Individual
CHARLES D WOOTTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 JOHNSON FERRY RD, SUITE 800, ATLANTA, GA 30342-1709
(404) 252-1137
(404) 252-6794
Mailing address
5780 PEACHTREE DUNWOODY ROAD, SUITE 300, ATLANTA, GA 30342-1513
(404) 303-1224
(404) 303-1325
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
035790
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000692887AA
—
GA
05
—
000692887AE
—
GA
05
—
000692887AF
—
GA
05
—
000692887Z
—
GA
Enumeration date
04/13/2006
Last updated
08/08/2013
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