Provider Demographics
NPI:1871725465
Name:WOODFIN NEUROLOGICAL CLINIC PA
Entity type:Organization
Organization Name:WOODFIN NEUROLOGICAL CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:SMILEY
Authorized Official - Last Name:WOODFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-390-2818
Mailing Address - Street 1:1105 CENTRAL EXPY N
Mailing Address - Street 2:SUITE 310B
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6103
Mailing Address - Country:US
Mailing Address - Phone:972-390-2818
Mailing Address - Fax:214-509-0272
Practice Address - Street 1:1105 CENTRAL EXPY N
Practice Address - Street 2:SUITE 310B
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6103
Practice Address - Country:US
Practice Address - Phone:972-390-2818
Practice Address - Fax:214-509-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD52552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty