JERRY L. WOOLUM, M.D., P.S.C. (NPI# 1265445845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265445845 |
| Entity Type | Organization |
| Organization Name | JERRY L. WOOLUM, M.D., P.S.C. |
| Other Organization Name | WOOLUM & COMBS-WOOLUM, P.S.C. |
| Practice Address |
121 Virginia Avenue Suite F200 Pineville KY 40977 |
| Practice Telephone | 6063370860 |
| Practice Fax Number | 6063379956 |
| Mailing Telephone | 6063370860 |
| Mailing Fax Number | 6063379956 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2014-10-14 |
| Authorized Official Name | MR. JERRY L WOOLUM (MD) |
| Authorized Official Telephone | 6063370860 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 65936379 | 05 |
| Other Name | Type Code |
|---|---|
| WOOLUM & COMBS-WOOLUM, P.S.C. | Former Legal Business Name - Organization |
| Street Address |
121 VIRGINIA AVENUE SUITE F200 |
| City | PINEVILLE |
| State | KY |
| Zip Code | 40977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669072757 | Arh Mary Breckinridge Health Services, Inc. | Clinic/Center | 302 Walnut Street, Pineville, KY 40977 | 2020-10-28 |
| 1780217794 | Family Health Care Associates 5 Limited Liability Company | Clinic/Center | 74 H&b Partin Lane, Pineville, KY 40977 | 2020-02-18 |
| 1033600416 | Southeast Family Practice Psc | Nurse Practitioner | 12904 Robert L Madon Byp Ste 2, Pineville, KY 40977 | 2018-05-22 |
| 1265971709 | Matthew Scott Powers | Physical Therapist | 103 Pine St., Pineville, KY 40977 | 2017-02-16 |
| 1316343130 | Lenn Neal | Counselor | 62 Phil Gibson Rd, Pineville, KY 40977 | 2014-11-05 |
| 1508092040 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 528 W Tennessee Ave., Pineville, KY 40977 | 2009-06-10 |
| 1477710770 | Jimmie Howard | Physical Therapy Assistant | Rt 1 Box 102, Pineville, KY 40977 | 2008-05-22 |
| 1932376175 | Kenny D Maynes | Occupational Therapist | Us 25e South, Britthaven of Pineville, Pineville, KY 40977 | 2008-05-15 |
| 1487862991 | Joanne D. Corum | General Practice | Rr 1 Box 173 Kingdom Come Parkway, Pineville, KY 40977 | 2007-05-18 |
| 1518171685 | Vivian Elesa Lasley | Contractor | Hwy 190 W, Reece Subdivision, Pineville, KY 40977 | 2007-05-09 |
| Find all providers in zip 40977 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255400511 | Vaman Shripad Diwan | Surgery | 335 Williamson Ave, Pineville, WV 24874-1470 | 2006-11-08 |
| 1033292461 | Bruce Edward Rayburn | Surgery | 390 Griffith St, Pineville, LA 71360 | 2006-10-21 |
| 1154412856 | Dave M. Rayburn | Surgery | 390 Griffith St., Pineville, LA 71360 | 2006-09-27 |
| 1467496190 | Huey P. Long Medical Center | Surgery | 352 Hospital Rd, Pineville, LA 71360 | 2006-06-15 |
| 1629018346 | Jean Baptiste Dorval | Surgery | 352 Hospital Blvd, Pineville, LA 71361-5352 | 2006-06-08 |
| 1982692364 | Ihor Andrew Zakaluzny | Surgery | 2495 Shreveport Hwy # 71, Pineville, LA 71360-4044 | 2005-10-11 |
| 1477759918 | Hays Surgery Group, Pllc | Surgery | 121 W Virginia Ave, Suite H-100, Pineville, KY 40977-1600 | 2007-06-22 |
| 1295806545 | William T Gaunt | Surgery | 850 Riverview Ave, Pineville, KY 40977-1452 | 2006-11-10 |
| 1801970397 | Watts R Webb | Surgery | 352 Hospital Blvd, Pineville, LA 71361-5352 | 2006-10-24 |
| 1730107699 | James Harrison Muchmore | Surgery | 352 Hospital Blvd, Pineville, LA 71360-6903 | 2006-07-18 |
| Find all providers in PINEVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.