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General NPI Number Information
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NPI Number | 1114813888
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Entity Type | Individual
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Provider Name | CALEB WOOD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 340 W 10TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-3082
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Country | US
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Telephone | 317-274-8157
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Fax |
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Provider Business Mailing Address
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Address Line | 6746 S 850 E
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City | ZIONSVILLE
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State | IN
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Zip | 46077-8266
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Country | US
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Telephone | 317-445-2018
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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