Organization
X-RAY PHYSICIANS OF SHELBYVILLE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BIELEFELD MD (GROUP PRESIDENT)
(317) 392-3211
Entity
Organization
Contact information
Practice address
2451 INTELLIPLEX DR, SHELBYVILLE, IN 46176-8580
(317) 392-3211
Mailing address
PO BOX 9730, LONGVIEW, TX 75608-9730
(903) 663-4800
(419) 223-2726
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000103450
ANTHEM BCBS
IN
05
—
100443670B
—
IN
01
—
CB9918
RAILROAD MEDICARE
IN
Enumeration date
03/08/2007
Last updated
04/15/2025
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