Organization
FIVE J WOODALL MEDICAL DIRECTOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN W WOODALL (M.D.) (OWNER)
(765) 642-8446
Entity
Organization
Contact information
Practice address
299 E 360 N, ANDERSON, IN 46012-9659
(765) 642-8446
(765) 642-7934
Mailing address
299 E 360 N, ANDERSON, IN 46012-9659
(765) 642-8446
(765) 642-7934
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01022907A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100171870A
—
IN
Enumeration date
03/26/2007
Last updated
06/21/2010
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