Woodruff, Alexis Crane

Woodruff, Alexis Crane is an sole proprietor health care provider with primary practice located at 5734 Coventry Lane , Fort Wayne IN 45804-7141. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Woodruff, Alexis Crane can be contacted via phone (260) 436-7875.

Contact Information

Primary practice address
5734 Coventry Lane Fort Wayne IN 45804-7141
Phone: (260) 436-7875
Fax: (260) 432-9812
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 35717 Kentucky
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 01062207 Indiana
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 35717 Kentucky

Profile Details

NPI number 1750377347
LBN Legal business name Woodruff, Alexis Crane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2005
Last updated Sep 7th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750377347 NPPES
Kentucky MEDICAID 64024441

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