Provider Demographics
NPI:1750363354
Name:WOFFORD, JAMES LUCIUS (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LUCIUS
Last Name:WOFFORD
Suffix:
Gender:
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:MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-2011
Mailing Address - Fax:
Practice Address - Street 1:1200 N MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-3006
Practice Address - Country:US
Practice Address - Phone:336-713-9800
Practice Address - Fax:336-713-9681
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31937207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6079440Medicaid
WV3810002532Medicaid
NC8988741Medicaid
NC7461737OtherAETNA
NC88741OtherBCBS
NC26452OtherPARTNERS
NC39733OtherMEDCOST
SCQ31937Medicaid
C89613Medicare UPIN
NC110236168Medicare PIN
NC88741OtherBCBS