Individual
MR. DONALD JUDE VENNEKOTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
721 W 13TH ST, SUITE 220, JASPER, IN 47546-1817
(812) 482-4494
(812) 482-4499
Mailing address
721 W 13TH ST, SUITE 220, JASPER, IN 47546-1817
(812) 482-4494
(812) 482-4499
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01041321
IN
208600000X
Surgery Physician
Primary
01041321
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000022029
ATHEM BLUE CROSS
IN
01
—
000000220292
ANTHEM
IN
05
—
200002870
—
IN
Enumeration date
03/02/2006
Last updated
09/08/2008
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