Individual
MR. JEFFREY D AGRICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
277 E CARMEL DR, STE D, CARMEL, IN 46032-2609
(317) 846-4111
(317) 846-1767
Mailing address
3731 GUION ROAD, SUITE C, INDIANAPOLIS, IN 46222-7604
(317) 931-0661
(317) 927-0924
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07000947A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200409540
—
IN
Enumeration date
06/28/2005
Last updated
04/15/2013
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