Provider Demographics
NPI:1487601217
Name:WOODY, JAMES RICHARD II (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RICHARD
Last Name:WOODY
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 HOSPITAL ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-2430
Mailing Address - Country:US
Mailing Address - Phone:606-348-9343
Mailing Address - Fax:606-340-3258
Practice Address - Street 1:166 HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-2416
Practice Address - Country:US
Practice Address - Phone:606-348-9343
Practice Address - Fax:865-291-3228
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33157207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00350318OtherMEDICARE RAILROAD
KY64012461Medicaid
KY0955907Medicare PIN
KYP00350318OtherMEDICARE RAILROAD