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Individual

DR. JOSEPH WOODSON WOLFE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 HOSPITAL ST, SUITE 100A, BOONEVILLE, MS 38829-3354
(662) 720-9413
Mailing address
1812 GLEN OAKS LN, DYERSBURG, TN 38024-2402

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13642
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00124801
MS
Enumeration date
06/30/2005
Last updated
07/12/2007
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