Organization
GREENWOOD ORTHOPEDICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD W JACKSON MD (PHYSICIAN OWNER OF PRACTICE)
(317) 497-6497
Entity
Organization
Contact information
Practice address
1550 E COUNTY LINE RD, SUITE 200, INDIANAPOLIS, IN 46227
(317) 497-6497
(317) 497-6400
Mailing address
1550 E COUNTY LINE RD, SUITE 200, INDIANAPOLIS, IN 46227
(317) 497-6497
(317) 497-6400
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000308039
ANTHEM
—
05
—
200489270A
—
IN
Enumeration date
02/13/2006
Last updated
01/17/2013
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