Provider Demographics
NPI:1699784868
Name:WOODLAND, JOSHUA AARON (OD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:AARON
Last Name:WOODLAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1129 11TH ST SE
Mailing Address - Street 2:STE B
Mailing Address - City:DYERSVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52040-2418
Mailing Address - Country:US
Mailing Address - Phone:563-927-3759
Mailing Address - Fax:563-927-5582
Practice Address - Street 1:105 E BUTLER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-1606
Practice Address - Country:US
Practice Address - Phone:563-927-3759
Practice Address - Fax:563-927-5582
Is Sole Proprietor?:No
Enumeration Date:2006-08-06
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA2461152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO809608Medicare PIN