Provider Demographics
NPI:1649449224
Name:THOMAS JC WOODS MD PA
Entity type:Organization
Organization Name:THOMAS JC WOODS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-592-2122
Mailing Address - Street 1:603 BEAMAN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2650
Mailing Address - Country:US
Mailing Address - Phone:910-592-2122
Mailing Address - Fax:910-592-7196
Practice Address - Street 1:603 BEAMAN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2650
Practice Address - Country:US
Practice Address - Phone:910-592-2122
Practice Address - Fax:910-592-7196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25675207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8989150Medicaid
NC202520Medicare PIN
NC8989150Medicaid