Individual
DR. JIROJ THEPHASDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8695 CONNECTICUT ST STE D, MERRILLVILLE, IN 46410-6240
(219) 769-3812
(219) 736-5341
Mailing address
8695 CONNECTICUT ST STE D, MERRILLVILLE, IN 46410-6240
(219) 769-3812
(219) 736-5341
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01026596A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0091108085
BCBS OF ILLINOIS
IL
01
—
306516
BCBS OF INDIANA
IN
Enumeration date
03/01/2007
Last updated
07/08/2007
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