Individual
MICHAEL J WOODBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3002 N GERMANTOWN RD, BARTLETT, TN 38133-4023
(901) 861-2234
Mailing address
3002 N GERMANTOWN RD, BARTLETT, TN 38133-4023
(901) 861-2234
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
FSJ499
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070007680
RR MEDICARE
AR
01
—
070011483
RR MEDICARE
TN
05
—
126719001
—
AR
Enumeration date
08/22/2005
Last updated
12/01/2014
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