Individual
JASON WODLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3200 COLD SPRING RD APT 105, INDIANAPOLIS, IN 46222-1960
(818) 300-6509
Mailing address
3200 COLD SPRING RD APT 105, INDIANAPOLIS, IN 46222-1960
(818) 300-6509
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1780379172
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/10/2023
Last updated
07/24/2023
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