Provider Demographics
NPI:1891774832
Name:WOODS, WILLIAM D (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:WOODS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1498 MERCHANTS DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-5064
Mailing Address - Country:US
Mailing Address - Phone:770-445-2715
Mailing Address - Fax:770-445-5805
Practice Address - Street 1:1498 MERCHANTS DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-5064
Practice Address - Country:US
Practice Address - Phone:770-445-2715
Practice Address - Fax:770-445-5805
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA871GA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0137880001OtherPALMETTO DMERC
GA0147448OtherBLUE CROSS & BLUE SHIELD
GA55455754SAMedicare ID - Type Unspecified
GAT97933Medicare UPIN