Basic Information
Provider Information
NPI: 1891223988
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WOODROW
FirstName: ALEXANDER
MiddleName: MARTIN
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 629 S RIVERSIDE DR APT 221
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522465615
CountryCode: US
TelephoneNumber: 4085824145
FaxNumber:  
Practice Location
Address1: 200 HAWKINS DR DEPT OF
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193562210
FaxNumber: 3193562940
Other Information
ProviderEnumerationDate: 06/01/2017
LastUpdateDate: 05/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XDO204369ORN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000XR-10946IAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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