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Individual

JASON RANSOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12563 STATE ROAD 23, GRANGER, IN 46530-9226
(574) 335-8300
(574) 335-0775
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059
(574) 335-8707

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01059860A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102295241
ANTHEM BCBS
IN
05
200500100
IN
Enumeration date
01/26/2006
Last updated
03/27/2024
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