Individual
JOHN CONSTANTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
120 W MCKENZIE RD, SUITE F, GREENFIELD, IN 46140-1072
(317) 468-6200
(317) 468-6201
Mailing address
PO BOX 129, GREENFIELD, IN 46140-0129
(317) 468-6270
(317) 468-6268
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20090254A
IN
2084P0800X
Psychiatry Physician
20090254A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000275567
ANTHEM PIN#
IN
05
—
100232230
—
IN
05
—
200459330A
—
IN
01
—
7800235
AETNA PIN#
IN
Enumeration date
08/16/2005
Last updated
10/08/2010
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