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Individual

JACQUELIN B TELESFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 353-9515
(812) 353-9275
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01063057A
IN
207P00000X
Emergency Medicine Physician
4301041333
MI

Other

Enumeration date
07/11/2006
Last updated
01/12/2024
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