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Jennifer Lynn Woodard

Family Medicine

Allopathic & Osteopathic Physicians

415 Broad St Ste 410, Kingsport, TN 37660-4264

PECOS Enrollment

This provider is enrolled in PECOS as JENNIFER WOODARD.

Based on the most recent information from CMS, provider Jennifer Lynn Woodard is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1861768350
Provider Type
Individual
Full Name
Woodard, Jennifer Lynn
Title
Dr.
Credential
D.O.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
3/28/2012
Last Updated
10/8/2015

Contact Information

Practice Location

415 Broad St Ste 410, Kingsport, TN 37660-4264

(423) 239-9737

Unlisted Fax

Mailing Location

267 Dublin Rd, Johnson City, TN 37615-4709

(423) 829-7268

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 0102204114 Virginia
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License DO0000002677 Tennessee

Jennifer Lynn Woodard

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Bates, Chad

Optimum Primary Care Pc

Rajoo, Shari K

Greene, Nathaniel A

Vincent, Bruce S

Robbins, Sherry L

Winegar, Bruce C

Hunley, Ryan T

Tochev, Tihomir Ivanov

Jantzi, Curtis Matthew