Individual
JAKE MATTHEW WEBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1415 STADIUM WAY UNIT 4202, INDIANAPOLIS, IN 46202-2160
(765) 414-4456
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10005135A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106266203
ANTHEM PTAN
IN
05
—
300125714
—
IN
Enumeration date
06/16/2023
Last updated
07/10/2026
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