Woodside, Kenneth Jeffrey
Woodside, Kenneth Jeffrey is an individual health care provider with primary practice located at 1500 E Medical Center Dr , Ann Arbor MI 48109-5000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Woodside, Kenneth Jeffrey can be contacted via phone (734) 936-4000.Contact Information
Primary practice address
1500 E Medical Center Dr
Ann Arbor MI 48109-5000
Phone: (734) 936-4000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 35-093946 | Ohio |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | M2206 | Texas |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 4301088944 | Michigan |
Profile Details
| NPI number | 1588603732 |
|---|---|
| LBN Legal business name | Woodside, Kenneth Jeffrey |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 5th, 2006 |
| Last updated | Aug 27th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588603732 | NPPES |
| Texas | Other | 01940834 | TX. DRIVER'S LICENSE |
| Texas | MEDICAID | 2962398 | TX. DRIVER'S LICENSE |
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