Individual
EDITH WOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3106 MERCER UNIVERSITY DR, MACON, GA 31204-5109
(478) 314-0890
(478) 314-0894
Mailing address
3106 MERCER UNIVERSITY DR, MACON, GA 31204-5109
(478) 314-0890
(478) 314-0894
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
28673
GA
207Q00000X
Family Medicine Physician
Primary
028673
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008829
BLUE CROSS
GA
05
—
564758011A
—
GA
Enumeration date
07/05/2006
Last updated
02/02/2010
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