Provider Demographics
NPI:1699126441
Name:WOODWARD, KIEL
Entity type:Individual
Prefix:
First Name:KIEL
Middle Name:
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:982045 NEBRASKA MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-2045
Mailing Address - Country:US
Mailing Address - Phone:402-559-5804
Mailing Address - Fax:402-559-9213
Practice Address - Street 1:982045 NEBRASKA MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-2045
Practice Address - Country:US
Practice Address - Phone:402-559-5804
Practice Address - Fax:402-559-9213
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE78032084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology