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General NPI Number Information
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NPI Number | 1154926715
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Entity Type | Individual
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Provider Name | LUCAS WOODALL PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | EMORY TRANSPLANT CENTER 1365 ECLIFTON RD NE BLDG B
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City | ATLANTA
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State | GA
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Zip | 30322-1179
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Country | US
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Telephone | 855-366-7989
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Fax |
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Provider Business Mailing Address
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Address Line | 61 WHITCHER ST NE STE 3110
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City | MARIETTA
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State | GA
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Zip | 30060-1179
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Country | US
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Telephone | 770-422-2326
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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 | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | 10276
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10276
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License Number State | GA
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