# JON D. MISCH, D.O.,P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972716082
- **Authorized official:** DR. JON D. MISCH D.O. (PRESIDENT)
- **Authorized official phone:** (219) 374-5555

## Contact information

- **Practice address:** 13963 MORSE ST, CEDAR LAKE, IN 46303-9639
- **Practice address phone:** (219) 374-5555
- **Practice address fax:** (219) 374-6669
- **Mailing address:** 13963 MORSE ST, CEDAR LAKE, IN 46303-9639
- **Mailing address phone:** (219) 374-5555
- **Mailing address fax:** (219) 374-6669

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 02000900 | IN | Yes |

## Other

- **Enumeration date:** 05/07/2007
- **Last updated:** 05/07/2010