Provider Demographics
NPI:1134151509
Name:WOODS, CAROLYN OWENS (MD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:OWENS
Last Name:WOODS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 UNION AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3641
Mailing Address - Country:US
Mailing Address - Phone:901-866-8622
Mailing Address - Fax:
Practice Address - Street 1:6401 POPLAR AVE STE 190
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4810
Practice Address - Country:US
Practice Address - Phone:901-866-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11617207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN626001636OtherUNITED HEALTHCARE
TN626001636OtherBAPTIST HEALTH SERVICES G
TN2621437OtherCIGNA
TN3194731Medicaid
TN37375OtherTLC
TN555788OtherUAHC
TN626001636OtherUSA MANAGED CARE
MS07236363Medicaid
AR213513001Medicaid
MO1134151509Medicaid
TN4135154OtherBLUE CROSS BLUE SHIELD
TN626001636OtherHEALTH CHOICE
TN184369OtherUNISON