Individual
JIANAN GRAYBILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7229 CLEARVISTA DR, INDIANAPOLIS, IN 46256-1698
(317) 621-5656
(317) 621-4366
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01040969A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100321780
—
IN
01
—
P01157042
RR MEDICARE PTAN
IN
Enumeration date
05/27/2005
Last updated
11/27/2023
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