Individual
JERRY WARREN WHETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2901 W JACKSON ST, MUNCIE, IN 47304-4307
(765) 751-5010
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01051865
IN
207Q00000X
Family Medicine Physician
Primary
01051865A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000308400
ANTHEM
—
05
—
200249490
—
IN
01
—
8659
PHP
—
Enumeration date
07/08/2005
Last updated
10/08/2025
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