Individual
DR. JON CHRISTOPHER MARKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
53880 CARMICHAEL DR, SOUTH BEND, IN 46635-1567
(574) 247-9441
(574) 247-9442
Mailing address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01048320A
IN
208100000X
Physical Medicine & Rehabilitation Physician
4301059960
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104309744
MEDICAID
MI
05
—
200296470
—
IN
Enumeration date
09/21/2006
Last updated
09/05/2024
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