MEDICARE: RONALD ALLEN WOODS DC

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	111N00000X	Chiropractor	08001962A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000298226	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1609979285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD ALLEN WOODS DC

Provider Business Mailing Address
First Line	:	8509 WESTFIELD BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-2369
Country	:	US
Telephone Number	:	317-257-3919
Fax Number	:	317-257-3919

Provider Business Practice Location Address
First Line	:	8509 WESTFIELD BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-2369
Country	:	US
Telephone Number	:	317-257-3919
Fax Number	:	317-257-3919

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

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	03/05/2008

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