Provider Demographics
NPI:1396896379
Name:WOODALL, GILBERT EARL JR (MD)
Entity type:Individual
Prefix:
First Name:GILBERT
Middle Name:EARL
Last Name:WOODALL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9314 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7462
Mailing Address - Country:US
Mailing Address - Phone:615-516-2974
Mailing Address - Fax:888-516-2974
Practice Address - Street 1:983 NISSAN DR
Practice Address - Street 2:CHS MEDICAL - NISSAN
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-4405
Practice Address - Country:US
Practice Address - Phone:615-459-1944
Practice Address - Fax:615-459-1898
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD00000110692083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine