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NPI Code Detail

MEDICARE: JASON FREDERICK WOODWARD MD

MEDICARE: JASON FREDERICK WOODWARD 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
1207R00000XInternal Medicine Physician35122280OH
2208000000XPediatrics Physician35122280OH
3208000000XPediatrics Physician01062565AIN

General Provider Information

NPI Number : 1972726123
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON FREDERICK WOODWARD MD
Provider Business Mailing Address
First Line : PO BOX 778912
Second Line :
City : CHICAGO
State : IL
Zip : 60677-8912
Country : US
Telephone Number : 317-777-6435
Fax Number : 317-777-6910
Provider Business Practice Location Address
First Line : 5515 W 38TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46254-2995
Country : US
Telephone Number : 317-880-3838
Fax Number : 317-880-0081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 04/24/2025

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Directions to “ JASON FREDERICK WOODWARD MD” Practice Location

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