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NPI Code Detail

MEDICARE: DR. CARL WILLIAM WOOLDRIDGE D.O.

MEDICARE:  DR. CARL WILLIAM WOOLDRIDGE  D.O.
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
1207X00000XOrthopaedic Surgery Physician02001243AIN
2207X00000XOrthopaedic Surgery Physician34008547OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2200008984OTHERINRAILROAD MEDICARE

Other Identifiers

General Provider Information

NPI Number : 1841262813
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARL WILLIAM WOOLDRIDGE D.O.
Provider Business Mailing Address
First Line : 5515 CEDAR BRANCH CIR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-3924
Country : US
Telephone Number : 765-966-8509
Fax Number :
Provider Business Practice Location Address
First Line : 5515 CEDAR BRANCH CIR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-3924
Country : US
Telephone Number : 765-966-8509
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 01/08/2016

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Directions to “ DR. CARL WILLIAM WOOLDRIDGE D.O.” Practice Location

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