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Individual

NEVA M LYNCH JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1601 MEDICAL ARTS BLVD, SUITE 201, ANDERSON, IN 46011-3459
(765) 298-4500
(765) 298-4900
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01060972A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000492794
ANTHEM
IN
05
200826430
IN
01
P01018475
RR MEDICARE
IN
Enumeration date
05/15/2006
Last updated
11/27/2023
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