Woodbury, Wayne M

Woodbury, Wayne M is an individual health care provider with primary practice located at 316 Marketplace Dr Ste 20 , Johnson City TN 37604-2596. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Woodbury, Wayne M can be contacted via phone (423) 794-5580.

Contact Information

Primary practice address
316 Marketplace Dr Ste 20 Johnson City TN 37604-2596
Phone: (423) 794-5580
Fax: (423) 232-8561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 042978 Georgia
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 8397828-1205 Utah
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 24642 Tennessee

Profile Details

NPI number 1770572893
LBN Legal business name Woodbury, Wayne M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Oct 20th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770572893 NPPES
Georgia MEDICAID 000729385A
Georgia Other 552387
Georgia MEDICAID 000729385C
Georgia MEDICAID 000729385D
Georgia Other 01352928
Georgia MEDICAID Q010272
Georgia MEDICAID G42978
Georgia Other P00795760

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