Provider Demographics
NPI:1770570871
Name:WOODY, JONATHAN DEWEY (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DEWEY
Last Name:WOODY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1357 OCONEE CONNECTOR BLDG 300
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7314
Mailing Address - Country:US
Mailing Address - Phone:706-549-8306
Mailing Address - Fax:706-549-8351
Practice Address - Street 1:1357 OCONEE CONNECTOR BLDG 300
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7314
Practice Address - Country:US
Practice Address - Phone:706-549-8306
Practice Address - Fax:706-549-8351
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2021-01-13
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Provider Licenses
StateLicense IDTaxonomies
GA0565092086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery