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Individual

WAYNE M WOODBURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
435 CHEROKEE MOUNTAIN RD, JONESBOROUGH, TN 37659-6637
(912) 596-2341
Mailing address
435 CHEROKEE MOUNTAIN RD, JONESBOROUGH, TN 37659-6637

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
042978
GA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
24642
TN
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
8397828-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000729385A
GA
05
000729385C
GA
05
000729385D
GA
01
01352928
AMERIGROUP
01
552387
WELLCARE MEDICAID & MEDICARE
GA
05
G42978
SC
01
P00795760
RR MEDICARE
GA
05
Q010272
TN
Enumeration date
10/20/2005
Last updated
10/02/2025
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