Individual
JEFFREY A VANCUREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1025 MICHIGAN AVE, SUITE 115, LOGANSPORT, IN 46947-1593
(574) 722-3566
(574) 753-6118
Mailing address
1025 MICHIGAN AVE, SUITE 115, LOGANSPORT, IN 46947-1593
(574) 722-3566
(574) 753-6118
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01046838
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000524942
ANTHEM BLUE CROSS
IN
05
—
200124110
—
IN
05
—
200124110A
—
IN
Enumeration date
03/27/2006
Last updated
07/26/2011
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