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Individual

MARK A TRUAX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 N LEBANON ST, JAMESTOWN, IN 46147-9372
(765) 676-5754
(765) 676-9853
Mailing address
2705 N LEBANON ST STE 305, LEBANON, IN 46052-8622
(765) 485-8852

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01032015
IN
207Q00000X
Family Medicine Physician
Primary
01032015A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100324100
IN
Enumeration date
06/21/2006
Last updated
04/15/2021
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