# G.E. WIDDIFIELD, M.D.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124213319
- **Authorized official:** MR. JOHN FREMONT WIDDIFIELD (ADMINISTRATOR)
- **Authorized official phone:** (317) 787-7902

## Contact information

- **Practice address:** 6249 S EAST ST, SUITE H, INDIANAPOLIS, IN 46227-2091
- **Practice address phone:** (317) 787-7902
- **Practice address fax:** (317) 787-7912
- **Mailing address:** 6249 S EAST ST, SUITE H, INDIANAPOLIS, IN 46227-2091
- **Mailing address phone:** (317) 787-7902
- **Mailing address fax:** (317) 787-7912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | IN01017158 | IN | Yes |

## Other

- **Enumeration date:** 09/11/2007
- **Last updated:** 09/11/2007