Provider Demographics
NPI:1730676164
Name:WOODS, KATHLEEN ELIZABETH (DO)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ELIZABETH
Last Name:WOODS
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 HOWARD AVE STE F4
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4818
Mailing Address - Country:US
Mailing Address - Phone:814-889-2701
Mailing Address - Fax:
Practice Address - Street 1:501 HOWARD AVE STE F2
Practice Address - Street 2:ALTOONA FAMILY PHYSICIANS
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4818
Practice Address - Country:US
Practice Address - Phone:814-889-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC83479207QA0505X
390200000X
PAOS020392207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program