Individual
DR. JAGANNATH K DIXIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8865 W 400 NO., #115, MICHIGAN CITY, IN 46360-9223
(219) 872-7268
(219) 872-2224
Mailing address
8865 W 400 NO., #115, MICHIGAN CITY, IN 46360-9223
(219) 872-7268
(219) 872-2224
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01028883A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000363639
BC BS
IN
05
—
200405570
—
IN
01
—
P00231139
RAILROAD MEDICARE
IN
Enumeration date
07/15/2005
Last updated
04/14/2011
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