Provider Demographics
NPI:1255029195
Name:WOODSON, PEGGY HILL
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:HILL
Last Name:WOODSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44309-0303
Mailing Address - Country:US
Mailing Address - Phone:330-303-1980
Mailing Address - Fax:
Practice Address - Street 1:4496 LONGLEAF RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-5007
Practice Address - Country:US
Practice Address - Phone:330-510-9928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health