Individual
JONATHAN P. GENTILE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13225 N MERIDIAN ST, CARMEL, IN 46032-5480
(317) 228-7000
(317) 577-0619
Mailing address
13225 N MERIDIAN ST, CARMEL, IN 46032-5480
(317) 228-7000
(317) 228-2321
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
01039604A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000032231
M-PLAN PROVIDER NUMBER
IN
01
—
000000369670
ANTHEM PROVIDER NUMBER
IN
05
—
200005430
—
IN
01
—
P00277537
MEDICARE RAILROAD
IN
Enumeration date
10/03/2006
Last updated
05/27/2016
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