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Individual

JODY A. UNDERWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
593 EDDY ST, APC 948, PROVIDENCE, RI 02903-4923
(401) 444-3534
(401) 444-3298
Mailing address
593 EDDY ST, APC 978 A, PROVIDENCE, RI 02903-4923
(401) 444-4318
(401) 444-6572

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD10700
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007009540
MEDICARE ID-TYPE UNSPECIFIED
RI
01
1093831646
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE NPI
01
1104801349
BUTLER HOSPITAL NPI
RI
01
15-76362
UNITED BEHAVIORAL HEALTH
RI
01
1528003712
NPI
RI
01
26418-3
BLUE CROSS
RI
01
409612
BLUE CHIP
RI
05
7009540
RI
Enumeration date
06/19/2006
Last updated
06/23/2008
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