Individual
JORDAN GEROSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1381 N WAYNE ST, ANGOLA, IN 46703-2348
(260) 665-8222
Mailing address
416 E MAUMEE ST, ANGOLA, IN 46703-2015
(260) 667-5131
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02006037A
IN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
02006037A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11019303A
STATE LICENSE
IN
05
—
300004615
—
IN
Enumeration date
06/18/2017
Last updated
02/03/2026
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