Individual
JAMES LEROY SPRINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 FOXBOROUGH RUN, SHELBYVILLE, IN 46176
(317) 512-2711
Mailing address
104 FOXBOROUGH RUN, SHELBYVILLE, IN 46176-2879
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01065737A
IN
207Q00000X
Family Medicine Physician
MD17476
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032073
—
OR
01
—
1407812365
NBMC GROUP NPI NUMBER
OR
05
—
201195760
—
IN
01
—
CB3544
RR MEDICARE GROUP NUMBER
OR
01
—
P00143357
RR MEDICARE PTAN NUMBER
OR
01
—
P01307618
MEDICARE RR PTAN
IN
01
—
R0000WFBTV
MEDICARE GROUP PIN NUMBER
OR
Enumeration date
12/20/2005
Last updated
06/19/2019
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