MEDICARE: DR. TONI ELDRIDGE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	01040068A	IN

General Provider Information

NPI Number	:	1598904781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TONI ELDRIDGE M.D.

Provider Business Mailing Address
First Line	:	8023 MILL POND LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-2104
Country	:	US
Telephone Number	:	317-298-4243
Fax Number	:	317-298-4264

Provider Business Practice Location Address
First Line	:	8023 MILL POND LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-2104
Country	:	US
Telephone Number	:	317-298-4243
Fax Number	:	317-298-4264

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2009
Last Update Date	:	02/11/2009

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