Provider Demographics
NPI:1538156674
Name:WOODS, MARK A (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:WOODS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3544 GRAND ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2926
Mailing Address - Country:US
Mailing Address - Phone:205-454-1483
Mailing Address - Fax:205-343-7425
Practice Address - Street 1:600 34TH ST
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-3393
Practice Address - Country:US
Practice Address - Phone:205-339-5900
Practice Address - Fax:205-343-7425
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12835207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51047977OtherBLUE CROSS/ BLUE SHIELD