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NPI 1063655769

NPI 1063655769 : JOHN HIRAM WOODRUFF M.D. : ATLANTA, GA

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General NPI Number Information
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    NPI Number           |    1063655769
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    Entity Type          |    Individual 
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    Provider Name        |    JOHN HIRAM WOODRUFF M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/09/2009
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    Last Update Date     |    12/02/2020
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Provider Practice Location Address
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    Address Line         |    1968 PEACHTREE RD NW 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30309
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    Country              |    US
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    Telephone            |    404-605-5000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2727 PACES FERRY RD SE STE 1-1100 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30339-6151
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    Country              |    US
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    Telephone            |    470-271-3418
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    2012-01106
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    License Number State |    NC
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Taxonomy #2
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    066442
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    License Number State |    GA
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