Dr Jhade Woodall, MD | |
3200 Channing Way Ste 206, Idaho Falls, ID 83404-7546 | |
(208) 529-2230 | |
(208) 453-6142 |
Full Name | Dr Jhade Woodall |
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Gender | Male |
Speciality | Plastic Surgery |
Location | 3200 Channing Way Ste 206, Idaho Falls, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053606236 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208200000X | Plastic Surgery | M-16557 (Idaho) | Primary |
Entity Name | Summit Orthopaedics Management And Consulting, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851485031 PECOS PAC ID: 6204731227 Enrollment ID: O20031203000543 |
Entity Name | Idaho Physician Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902841893 PECOS PAC ID: 2163430943 Enrollment ID: O20070208000680 |
Mailing Address | Practice Location Address |
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Dr Jhade Woodall, MD Po Box 277381, Atlanta, GA 30384-2358 Ph: () - | Dr Jhade Woodall, MD 3200 Channing Way Ste 206, Idaho Falls, ID 83404-7546 Ph: (208) 529-2230 |
Dr. William P.d. Wilson Iii, M.D. Plastic Surgery Medicare: Accepting Medicare Assignments Practice Location: 2860 Channing Way, Suite 112, Idaho Falls, ID 83404 Phone: 208-524-4381 Fax: 208-523-6477 | |
Nicholas Bradford Johnson, Plastic Surgery Medicare: Accepting Medicare Assignments Practice Location: 3200 Channing Way Ste 206, Idaho Falls, ID 83404 Phone: 208-529-2230 Fax: 208-453-6142 |