Individual
JOHN MONTGOMERY WOODYEAR,JR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
507 N MAIN ST, TROY, NC 27371-2709
(910) 576-0042
(910) 576-1442
Mailing address
507 N MAIN ST, TROY, NC 27371-2709
(910) 576-0042
(910) 576-1442
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9500278
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8988912
—
NC
01
—
QPA139
MEDICAID
SC
Enumeration date
09/29/2006
Last updated
07/08/2007
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