Provider Demographics
NPI:1770893752
Name:WOODS, ANDREW D (DPM)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:D
Last Name:WOODS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 W ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-5337
Mailing Address - Country:US
Mailing Address - Phone:912-283-7596
Mailing Address - Fax:912-283-1618
Practice Address - Street 1:401 WOODROW WILSON DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2628
Practice Address - Country:US
Practice Address - Phone:229-247-7707
Practice Address - Fax:229-245-8707
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPOD001157213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003108321AMedicaid
P00949914OtherRAILROAD MEDICARE
202I487447Medicare PIN