Healthcare Provider Details

I. General information

NPI: 1770710071
Provider Name (Legal Business Name): ZAKIYA DONELSON WOODS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3481 AUSTIN PEAY HWY
MEMPHIS TN
38128-3801
US

IV. Provider business mailing address

2595 CENTRAL AVE
MEMPHIS TN
38104-5905
US

V. Phone/Fax

Practice location:
  • Phone: 901-260-8500
  • Fax: 901-260-8598
Mailing address:
  • Phone: 901-260-8500
  • Fax: 901-260-8598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number48834
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: