Individual
JAI KUMAR KHATRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 948-1310
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01081261A
IN
207R00000X
Internal Medicine Physician
63915
WI
207RH0003X
Hematology & Oncology Physician
01081261A
IN
207RX0202X
Medical Oncology Physician
01081261A
IN
208M00000X
Hospitalist Physician
Primary
63915
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001217230
ANTHEM PTAN
IN
01
—
068010477
MEDICARE PTAN
IN
05
—
300020278
—
IN
Enumeration date
06/25/2012
Last updated
05/31/2024
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