Individual
JENNIFER BALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1100 REID PKWY, EMERGENCY DEPARTMENT, RICHMOND, IN 47374-1157
(765) 983-3144
(765) 983-3038
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 983-3127
(765) 983-3219
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01057866A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001235611
ANTHEM
IN
05
—
200077090
—
IN
05
—
3045949
—
OH
Enumeration date
09/28/2006
Last updated
05/12/2021
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