Individual
DR. JASON M FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 RONALD REAGAN PKWY, RADIOLOGY RM 11078, AVON, IN 46123-7085
(317) 715-6402
(317) 715-6415
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01062397A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000613014
ANTHEM BCBS
IN
05
—
200911710
—
IN
01
—
P00650447
RAILROAD MEDICARE
IN
01
—
P00742642
RAILROAD MEDICARE
IN
Enumeration date
12/21/2007
Last updated
01/26/2021
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