DR. STEPHANIE WOO, OD - NPI NUMBER 1922396076

Summary

Provider Name: DR. STEPHANIE WOO, OD

NPI Number: 1922396076

Clasification: Optometrist (152W00000X)

Organization: STUART ADAMS O.D PC

Address:
383 LAKE HAVASU AVE S
LAKE HAVASU CITY, AZ
ZIP 86403

Phone Number: (928) 680-1144



Detailed Information

DR. Stephanie Woo, OD is an optometrist in Lake Havasu City, AZ with 3 years of experience. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. The assigned NPI number for this provider is 1922396076 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Graduation Year: 2011

The provider's business address is:

383 LAKE HAVASU AVE S
LAKE HAVASU CITY, AZ
ZIP 86403-368
Phone: (928) 680-1144
Fax: (928) 680-8639

The enumeration date for this NPI number is 7/11/2011 and was last updated on 11/7/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 152W00000X Optometrist 2011019156 MO No
2 152WC0802X Optometrist Corneal and Contact Management 2011019156 MO No
3 152W00000X Optometrist 1812 AZ Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 991630007 MEDICARE PIN MO
2 067820020 MEDICARE PIN MO
3 1922396076 MEDICAID MO
4 Z155372 MEDICARE PIN AZ
5 074730021 MEDICARE PIN MO

NPI Record

No. Field Name Field Value
1 NPI 1922396076
2 Entity Type Code 1
3 Provider Last Name Legal Name WOO
4 Provider First Name STEPHANIE
5 Provider Name Prefix Text DR.
6 Provider Credential Text OD
7 Provider First Line Business Practice Location Address 383 LAKE HAVASU AVE S
8 Provider Business Practice Location Address City Name LAKE HAVASU CITY
9 Provider Business Practice Location Address State Name AZ
10 Provider Business Practice Location Address Postal Code 864039368
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 9286801144
13 Provider Business Practice Location Address Fax Number 9286808639
14 Provider Enumeration Date 7/11/2011
15 Last Update Date 11/7/2012
16 Provider Gender Code F
17 Healthcare Provider Taxonomy Code 1 152W00000X
18 Provider License Number 1 2011019156
19 Provider License Number State Code 1 MO
20 Healthcare Provider Primary Taxonomy Switch 1 N
21 Healthcare Provider Taxonomy Code 2 152WC0802X
22 Provider License Number 2 2011019156
23 Provider License Number State Code 2 MO
24 Healthcare Provider Primary Taxonomy Switch 2 N
25 Healthcare Provider Taxonomy Code 3 152W00000X
26 Provider License Number 3 1812
27 Provider License Number State Code 3 AZ
28 Healthcare Provider Primary Taxonomy Switch 3 Y
29 Other Provider Identifier 1 991630007
30 Other Provider Identifier Type Code 1 08
31 Other Provider Identifier State 1 MO
32 Other Provider Identifier 2 067820020
33 Other Provider Identifier Type Code 2 08
34 Other Provider Identifier State 2 MO
35 Other Provider Identifier 3 1922396076
36 Other Provider Identifier Type Code 3 05
37 Other Provider Identifier State 3 MO
38 Other Provider Identifier 4 Z155372
39 Other Provider Identifier Type Code 4 08
40 Other Provider Identifier State 4 AZ
41 Other Provider Identifier 5 074730021
42 Other Provider Identifier Type Code 5 08
43 Other Provider Identifier State 5 MO
44 Is Sole Proprietor N

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This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.