| Dwight Lee Stauffer, MD | |
|
2209 John R Wooden Dr, Martinsville, IN 46151-1840 | |
| (765) 352-9536 | |
| (765) 349-6433 |
| Full Name | Dwight Lee Stauffer |
|---|---|
| Gender | Male |
| Speciality | Obstetrics & Gynecology - Gynecology |
| Location | 2209 John R Wooden Dr, Martinsville, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811924475 | NPI | - | NPPES |
| 200377200 | Other | IN | MEDICAID GROUP |
| 1003455410 | Medicaid | IN | |
| 1104827633 | Other | IN | GROUP NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207VG0400X | Obstetrics & Gynecology - Gynecology | 01025006 (Indiana) | Primary |
| 207VX0000X | Obstetrics & Gynecology - Obstetrics | 01025006 (Indiana) | Secondary |
| Entity Name | Indiana University Health Paoli Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457519324 PECOS PAC ID: 2668426016 Enrollment ID: O20050308001174 |
| Entity Name | Obhg Indiana Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811232218 PECOS PAC ID: 7315185691 Enrollment ID: O20130528000323 |
| Mailing Address | Practice Location Address |
|---|---|
| Dwight Lee Stauffer, MD 4883 E Heritage Woods Rd, Bloomington, IN 47401-9313 Ph: (812) 320-0030 | Dwight Lee Stauffer, MD 2209 John R Wooden Dr, Martinsville, IN 46151-1840 Ph: (765) 352-9536 |
Dr. Lynnova J Reynolds, D.O. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 2209 John R Wooden Dr, Woman To Woman, Martinsville, IN 46151 Phone: 765-352-9536 Fax: 765-349-6433 |