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General NPI Number Information
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NPI Number | 1285457218
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Entity Type | Individual
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Provider Name | MR. JONAH EUGENE WOO
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Gender | Male
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 1325 SPRING ST
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City | GREENWOOD
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State | SC
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Zip | 29646-3875
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Country | US
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Telephone | 864-725-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 50 DELAUGHTER DR
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City | NORTH AUGUSTA
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State | SC
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Zip | 29860-8537
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Country | US
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Telephone |
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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 | 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 #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5650
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License Number State | SC
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