Individual
JASON K SORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7120 CLEARVISTA DR, SUITE 1500, INDIANAPOLIS, IN 46256-1621
(317) 621-9292
(317) 621-9299
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01061869A
IN
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
01061869A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000555974
ANTHEM
IN
05
—
20090050
—
IN
01
—
453271
WELLCARE
IN
01
—
9705140
AETNA
IN
01
—
P01292382
RAILROAD MEDICARE
IN
Enumeration date
04/19/2007
Last updated
11/27/2023
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