Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 21758 | TN |
N | 111NI0900X | Internist | 21758 | TN |
Y | 207RA0401X | Internist - Addiction Medicine | 21758 | TN |
NPI | 1861452849 |
---|---|
Provider Name | Dr. John B Woods |
First Address | Memphis, TN 38104-3641 |
Second Address | Memphis, TN 38119-4808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 04/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3082191 | (05) | TN |
30821911 | (05) | TN |
3082195 | (05) | TN |
4131246 | BCBS (01) | TN |
4164685 | BCBS (01) | TN |
F79235 | (02) | |
F79235 | (02) | TN |