Basic Information
| Provider Information | |||||||||
| NPI: | 1093080855 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WOODLAND INTERNATIONAL RESEARCH GROUP, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1014 AUTUMN RD | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012218681 | ||||||||
| FaxNumber: | 5012211553 | ||||||||
| Practice Location | |||||||||
| Address1: | 1014 AUTUMN RD | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722113704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012218681 | ||||||||
| FaxNumber: | 5012211553 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2012 | ||||||||
| LastUpdateDate: | 03/13/2012 | ||||||||
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| AuthorizedOfficialLastName: | WITHAM | ||||||||
| AuthorizedOfficialFirstName: | CAROL | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5012218681 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 541380 | AR | Y | Hospital Units | Psychiatric Unit |
No ID Information.