MEDICARE: DR. GEORGE ELLIS WOODMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	MD0000030177	TN

General Provider Information

NPI Number	:	1598860272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE ELLIS WOODMAN MD

Provider Business Mailing Address
First Line	:	350 N HUMPHREYS BLVD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-2177
Country	:	US
Telephone Number	:	901-226-4003
Fax Number	:	901-227-8591

Provider Business Practice Location Address
First Line	:	6027 WALNUT GROVE RD STE 319
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-2128
Country	:	US
Telephone Number	:	901-226-3882
Fax Number	:	901-226-3883

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	12/31/2025

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