Basic Information
| Provider Information | |||||||||
| NPI: | 1134151509 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOODS | ||||||||
| FirstName: | CAROLYN | ||||||||
| MiddleName: | OWENS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1407 UNION AVE STE 700 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381043641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018668622 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6401 POPLAR AVE STE 190 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381194810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018668700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 02/01/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 11617 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 626001636 | 01 | TN | UNITED HEALTHCARE | OTHER | 626001636 | 01 | TN | BAPTIST HEALTH SERVICES G | OTHER | 2621437 | 01 | TN | CIGNA | OTHER | 3194731 | 05 | TN | MEDICAID | 37375 | 01 | TN | TLC | OTHER | 555788 | 01 | TN | UAHC | OTHER | 626001636 | 01 | TN | USA MANAGED CARE | OTHER | 07236363 | 05 | MS | MEDICAID | 213513001 | 05 | AR | MEDICAID | 1134151509 | 05 | MO | MEDICAID | 4135154 | 01 | TN | BLUE CROSS BLUE SHIELD | OTHER | 626001636 | 01 | TN | HEALTH CHOICE | OTHER | 184369 | 01 | TN | UNISON | OTHER |