G.E. Widdifield, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

IN01017158 Issued in IN

Legal business name

G.E. WIDDIFIELD, M.D.

Practice address

6249 S East St
Suite H
Indianapolis, IN 46227-2091

Phone

(317) 787-7902

Fax

(317) 787-7912

NPI assigned

Sep 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John Fremont Widdifield

Title

Administrator

Phone

(317) 787-7902

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1124213319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6249 S EAST ST",
            "address_2": "SUITE H",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272091",
            "telephone_number": "317-787-7902",
            "fax_number": "317-787-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6249 S EAST ST",
            "address_2": "SUITE H",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272091",
            "telephone_number": "317-787-7902",
            "fax_number": "317-787-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G.E. WIDDIFIELD, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "WIDDIFIELD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "FREMONT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "317-787-7902",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "IN01017158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.