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Individual

JON J JANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12544 ANCHORAGE WAY, FISHERS, IN 46037-9586
(317) 915-1475
Mailing address
12544 ANCHORAGE WAY, FISHERS, IN 46037-9586

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01042313
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000085876
ANTHEM
IN
01
000000764306
ANTHEM
IN
01
020024683
MEDICARE RAILROAD
IN
05
100421600
IN
05
100421600A
IN
01
P01157045
MEDICARE RAILROAD
IN
Enumeration date
06/30/2005
Last updated
03/05/2025
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