Provider Demographics
NPI:1609979285
Name:WOODS, RONALD ALLEN (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:ALLEN
Last Name:WOODS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8509 WESTFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-2369
Mailing Address - Country:US
Mailing Address - Phone:317-257-3919
Mailing Address - Fax:317-257-3919
Practice Address - Street 1:8509 WESTFIELD BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-2369
Practice Address - Country:US
Practice Address - Phone:317-257-3919
Practice Address - Fax:317-257-3919
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001962A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000298226OtherANTHEM
IN221150AMedicare Oscar/Certification
83597Medicare UPIN