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Individual

JORDAN R LADEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
11725 N ILLINOIS ST, SUITE 250, CARMEL, IN 46032-3008
(317) 688-5300
(317) 688-5313
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001350A
IN

Other

Enumeration date
11/22/2011
Last updated
10/07/2016
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