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General NPI Number Information
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NPI Number | 1700833829
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Entity Type | Organization
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Legal Business Name | JIMMIE D. WOODLEE MD
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 155 HEALTH WAY SUITE 2
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City | MC MINNVILLE
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State | TN
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Zip | 37110-2658
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Country | US
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Telephone | 931-473-4214
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Fax | 931-473-0666
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Provider Business Mailing Address
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Address Line | 155 HEALTH WAY SUITE 2
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City | MC MINNVILLE
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State | TN
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Zip | 37110-2658
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Country | US
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Telephone | 931-473-4214
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Fax | 931-473-0666
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JIMMIE DALE WOODLEE
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Credential | M.D.
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Telephone | 931-473-4214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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