Individual
JERRY C WOODARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2605 FOREST HILLS RD SW, WILSON, NC 27893-4448
(252) 243-7977
(252) 399-0514
Mailing address
PO BOX 7014, WILSON, NC 27895-7014
(252) 243-7977
(252) 399-0514
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16053
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0225G
BLUE CROSS BLUE SHIELD
NC
05
—
8989085
—
NC
Enumeration date
03/05/2007
Last updated
03/04/2008
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