Individual
DR. JOHN D WOOTEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1520 SUNDAY DR, RALEIGH, NC 27607-5253
(919) 782-3456
(919) 787-7552
Mailing address
1540 SUNDAY DR, RALEIGH, NC 27607-6000
(919) 782-3456
(919) 787-7552
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
30263
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8912399
—
NC
Enumeration date
07/06/2006
Last updated
01/13/2011
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