MEDICARE: BETTY A ROUTLEDGE MD

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	207Q00000X	Family Medicine Physician	01036007A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093773269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTY A ROUTLEDGE MD

Provider Business Mailing Address
First Line	:	8910 PURDUE RD
Second Line	:	STE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-3161
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2732 W MICHIGAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-3750
Country	:	US
Telephone Number	:	317-554-4600
Fax Number	:	317-554-4617

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	08/05/2011

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