Individual
DR. JONATHON WADE CAVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2705 N LEBANON ST STE 310, LEBANON, IN 46052-8622
(765) 485-8900
(765) 485-8909
Mailing address
2705 N LEBANON ST STE 305, LEBANON, IN 46052-8622
(765) 485-8852
(765) 485-8669
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01064975A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200908670
—
IN
Enumeration date
05/22/2007
Last updated
07/21/2022
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