| Five J Woodall Medical Director | |
|
299 E 360 N Anderson IN 46012-9659 | |
| (765) 642-8446 | |
| (765) 642-7934 |
| Full Name | Five J Woodall Medical Director |
|---|---|
| Speciality | Family Medicine |
| Location | 299 E 360 N, Anderson, Indiana |
| Authorized Official Name and Position | John W Woodall (OWNER) |
| Authorized Official Contact | 7656428446 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Five J Woodall Medical Director 299 E 360 N Anderson IN 46012-9659 Ph: (765) 642-8446 | Five J Woodall Medical Director 299 E 360 N Anderson IN 46012-9659 Ph: (765) 642-8446 |
| NPI Number | 1013034628 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 06/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013034628 | NPI | - | NPPES |
| 100171870A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01022907A (Indiana) | Primary |
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