Individual
JONATHON CLARK HOSTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5550 S EAST ST STE 1, INDIANAPOLIS, IN 46227-1979
(317) 780-4080
(317) 780-4088
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01094065A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104205850
ANTHEM PTAN
IN
05
—
300051422
—
IN
Enumeration date
04/15/2021
Last updated
06/03/2025
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