Individual
DR. JEFFREY MANUEL TIOCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9132 COLUMBIA AVE, MUNSTER, IN 46321-2907
(219) 836-2225
(219) 836-3158
Mailing address
9136 COLUMBIA AVE, MUNSTER, IN 46321-2907
(219) 836-2225
(219) 836-3158
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01054586A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000207545
ANTHEM
IN
01
—
208965421
FISERV
—
01
—
208965421E
UNICARE
—
01
—
7195342
AETNA
—
01
—
90001346
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
03/07/2007
Last updated
02/21/2011
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