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JACK R WOODSIDE M.D.
NPI 1619953494
Family Medicine in Johnson City, TN

Active since December 22, 2005
917 W WALNUT ST, JOHNSON CITY, TN 37604(423) 439-6464(423) 439-7118 Get Directions Write a Review

NPPES record last updated: November 8, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jack R Woodside M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK R WOODSIDE M.D. (NPI 1619953494) is an individual family medicine provider in Johnson City, Tennessee, licensed in Tennessee (17275) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1619953494
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJACK R WOODSIDECredential: M.D.
Location Address917 W WALNUT STJohnson City, TN 37604-6527
Mailing AddressP.o.box 699Mountain Home, TN 37684 · (423) 439-6464 · Fax (423) 439-7118
Phone(423) 439-6464
Fax(423) 439-7118
Sole ProprietorNo
Enumeration DateDecember 22, 2005
Last NPPES UpdateNovember 8, 2010
✔ NPI 1619953494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TN · 17275
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
917 W WALNUT ST, Johnson City, TN 37604
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Other Identifiers 2

Medicare UPINA98503
Medicare ID-Type Unspecified3026479TN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NIKITA MARIE THOMPSON
Social Worker (Clinical)
917 W WALNUT ST
JOHNSON CITY, TN 37604
Washington County (423) 439-6464
MEDICAL EDUCATION ASSISTANCE CORPORATION
Family Medicine
917 W WALNUT ST
JOHNSON CITY, TN 37604
Washington County (423) 439-6464
AUSTIN B HASH DO
Student in an Organized Health Care Education/Training Program
917 W WALNUT ST
JOHNSON CITY, TN 37604
Washington County (423) 439-6464
DR. PAIGE MCCLEAR DO
Family Medicine
917 W WALNUT ST
JOHNSON CITY, TN 37604
Washington County (423) 439-6464
JIM L WILSON M.D.
Family Medicine
917 W WALNUT ST
JOHNSON CITY, TN 37604
Washington County (423) 439-6464
JOYCE ANNE TROXLER MD
Family Medicine
917 W WALNUT ST
JOHNSON CITY, TN 37604
Washington County (423) 439-6464
JAMES D HOLT M.D.
Family Medicine
917 W WALNUT ST
JOHNSON CITY, TN 37604
Washington County (423) 439-6464
DR. BENJAMIN DANIEL WHITFIELD D.O. M.S.W.
Family Medicine
917 W WALNUT ST
JOHNSON CITY, TN 37604
Washington County (423) 439-6464

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Woodside's NPI number?

The NPI number for Jack Woodside is 1619953494. It was assigned to this individual provider in the NPPES registry on December 22, 2005.

Where is Jack Woodside located?

Jack Woodside practices at 917 W Walnut St, Johnson City, TN 37604. The listed phone number is (423) 439-6464.

What is Jack Woodside's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Jack Woodside was last updated on November 8, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.