Healthcare Provider Details

I. General information

NPI: 1083083141
Provider Name (Legal Business Name): ABBY L BELK P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABBY L WOOD PA

II. Dates (important events)

Enumeration Date: 09/18/2015
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 S STATE ROAD 135 STE 310
GREENWOOD IN
46143-5527
US

IV. Provider business mailing address

6626 E 75TH ST STE 500
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 317-497-2400
  • Fax: 315-497-2515
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number085.005691
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10002252A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: