Provider Demographics
NPI:1104853639
Name:WOODS, SONJA B (MD)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:B
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 1:1225 E WEISGARBER RD
Mailing Address - Street 2:STE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:
Practice Address - Street 1:1404 TUSCULUM BLVD STE 3000
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4648
Practice Address - Country:US
Practice Address - Phone:423-638-1188
Practice Address - Fax:423-636-1514
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00297397OtherRR MEDICARE PIN
TNP00297397OtherRR MEDICARE PIN
TN3706633Medicare ID - Type UnspecifiedLEGACY GROUP
H75944Medicare UPIN