Individual
JEFFREY L AMODEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 JOHN R WOODEN DR, MARTINSVILLE, IN 46151-1863
(765) 342-5415
(765) 342-3415
Mailing address
PO BOX 1557, MARTINSVILLE, IN 46151-0557
(765) 349-4600
(765) 349-6590
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01068850A
IN
208600000X
Surgery Physician
234562
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027200501
UNIVERA
NY
01
—
000528151001
BC/BS
NY
01
—
01068850A
IN STATE LICENSE
IN
05
—
02656499
—
NY
01
—
050802000019
FIDELIS
NY
01
—
164405FL
PREFERRED CARE
NY
01
—
1712914
IHA
NY
Enumeration date
10/20/2005
Last updated
04/05/2012
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