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General NPI Number Information
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NPI Number | 1982688065
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Entity Type | Individual
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Provider Name | CHARLES REECE WOODS JR. MD
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Gender | Male
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 910 BLACKFORD ST
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City | CHATTANOOGA
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State | TN
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Zip | 37403-1405
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Country | US
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Telephone | 423-778-7289
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Fax | 423-778-6848
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Provider Business Mailing Address
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Address Line | 910 BLACKFORD ST
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City | CHATTANOOGA
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State | TN
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Zip | 37403-1405
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Country | US
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Telephone | 423-778-7289
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Fax | 423-778-6848
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 58055
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 40365
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 40365
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 58055
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License Number State | TN
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