Provider Demographics
NPI:1255625463
Name:WOFFORD, JOHN DAVID III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:WOFFORD
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:2500 N STATE ST
Mailing Address - Street 2:MEDICAL CENTER BLVD
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-984-5571
Mailing Address - Fax:601-984-5583
Practice Address - Street 1:2500 N STATE STREET
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-5571
Practice Address - Fax:601-984-5583
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2016-12-16
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Provider Licenses
StateLicense IDTaxonomies
MS24619207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS545467YJ5DMedicare PIN