Provider Demographics
NPI:1134346430
Name:WOODMANSEE, COURTNEY STROUPE (MD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:STROUPE
Last Name:WOODMANSEE
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 1:1455 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6727
Mailing Address - Country:US
Mailing Address - Phone:901-726-6655
Mailing Address - Fax:
Practice Address - Street 1:1455 UNION AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-6727
Practice Address - Country:US
Practice Address - Phone:901-726-6655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43509207ND0101X
KY40861207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology