William Richard Woodruff
Individual provider Active NPI Clinical Laboratory Director (Non-physician) · Lower Brule, SD
NPI 1053514554 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1053514554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Laboratory Director (Non-physician) 247ZC0005X
- Practice address
- 601 Gall Street
Lower Brule, SD 57548-0248 - Phone
- (605) 473-8246
- Fax
- (605) 473-0607
- NPI assigned
- Jun 11, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lower Brule Health Center IHS | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Laboratory Director (Non-physician) | 247ZC0005X | Yes |
Addresses
Primary practice location
601 Gall Street
Lower Brule, SD 57548-0248
Mailing address
PO Box 248
Lower Brule, SD 57548-0248
Phone (605) 473-8246
Other providers in Lower Brule, SD
- Richard P Thompson Jr.
- Christianna L Tran
- Elijah Sky Walls
- Danielle Weidenbach
- Georgia Wilson
- Michael David Yanuck
- Erica Brynn Zimprich
All providers in Lower Brule, SD · Clinical Laboratory Director (Non-physician) in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.