Woodruff, Robert Kelvin

Woodruff, Robert Kelvin is an sole proprietor health care provider with primary practice located at 3855 Azalea Drive , Jackson MS 39206-5105. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as his primary health care specialty. Woodruff, Robert Kelvin can be contacted via phone (601) 366-7063.

Contact Information

Primary practice address
3855 Azalea Drive Jackson MS 39206-5105
Phone: (601) 366-7063
Fax: (601) 366-7860
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 80102 Mississippi

Profile Details

NPI number 1336220177
LBN Legal business name Woodruff, Robert Kelvin
Credentials D.P.M., P.A.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 18th, 2006
Last updated Sep 10th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336220177 NPPES
Mississippi MEDICAID 0010072

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