Individual
JENNIFER R. HARTWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2150 25TH ST STE B, COLUMBUS, IN 47201-3243
(812) 376-9219
(812) 378-4821
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01069351A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000984526
ANTHEM PIN
—
05
—
201027470
—
IN
Enumeration date
07/21/2008
Last updated
09/06/2024
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