Provider Demographics
NPI:1295764959
Name:WOODS, CARLA Y (PA)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:Y
Last Name:WOODS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SISKIN PLZ
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-1306
Mailing Address - Country:US
Mailing Address - Phone:423-634-4226
Mailing Address - Fax:423-634-4222
Practice Address - Street 1:581 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4469
Practice Address - Country:US
Practice Address - Phone:305-651-1690
Practice Address - Fax:305-279-4916
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000001232363A00000X
GA004942363A00000X
FLPA9103000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3663211Medicaid
TN4101780OtherBCBSTN
Q36124Medicare UPIN
TN3663211Medicaid
TN4101780OtherBCBSTN