Individual
MR. JAMES ROBERT EMERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 FERRY ST, LAFAYETTE, IN 47904-3055
(765) 448-8000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
55058
MN
208M00000X
Hospitalist Physician
Primary
01073937A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000878677
ANTHEM PROVIDER NUMBER
IN
05
—
201227900
—
IN
Enumeration date
05/20/2010
Last updated
01/26/2021
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