MEDICARE: DR. JOHN B WOODS M.D.

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	207R00000X	Internal Medicine Physician	21758	TN
2	207RA0401X	Addiction Medicine (Internal Medicine) Physician	21758	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4164685	OTHER	TN	BCBS
2	4131246	OTHER	TN	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861452849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN B WOODS M.D.

Provider Business Mailing Address
First Line	:	1407 UNION AVE STE 700
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38104-3641
Country	:	US
Telephone Number	:	901-866-8622
Fax Number	:

Provider Business Practice Location Address
First Line	:	6401 POPLAR AVE STE 500
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-4808
Country	:	US
Telephone Number	:	901-866-8630
Fax Number	:

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	02/04/2019

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Directions to “ DR. JOHN B WOODS M.D.” Practice Location

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