Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 11303 | NC |
NPI | 1255397758 |
---|---|
Provider Name | Dr. Joe H Woody |
First Address | Charlotte, NC 28211-2347 |
Second Address | Charlotte, NC 28211-2347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8989170 | (05) | NC |
C87279 | (02) | NC |