Individual
JONATHAN TING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 UNIVERSITY BLVD STE 3170, INDIANAPOLIS, IN 46202-5149
(317) 948-3226
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01063758A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200987260
—
IN
Enumeration date
05/27/2008
Last updated
03/17/2021
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