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Organization

J.K.KANSAL MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JATINDER K KANSAL I M.D. (PRESIDENT)
(219) 769-7761
Entity
Organization

Contact information

Practice address
8969 BROADWAY, MERRILLVILLE, IN 46410-7039
(219) 769-7761
(219) 769-0895
Mailing address
8969 BROADWAY, MERRILLVILLE, IN 46410-7039
(219) 769-7761
(219) 769-0895

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01032298B
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100169090B
IN
Enumeration date
07/10/2012
Last updated
07/10/2012
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