Provider Demographics
NPI:1437415890
Name:WOODS, RACHEL P (DO)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:P
Last Name:WOODS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 775383
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-5383
Mailing Address - Country:US
Mailing Address - Phone:123-765-3158
Mailing Address - Fax:
Practice Address - Street 1:1120 N MARR RD
Practice Address - Street 2:COLUMBUS PEDIATRICS
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5505
Practice Address - Country:US
Practice Address - Phone:812-376-9219
Practice Address - Fax:812-378-4821
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004633A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201093450Medicaid