Individual
JAMES PHOTIADIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2015 JACKSON ST, ANDERSON, IN 46016-4337
(812) 649-2511
(812) 649-7867
Mailing address
4243 SUN RIDGE DR, NEW ALBANY, IN 47150-9255
(812) 949-5214
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01061798A
IN
207L00000X
Anesthesiology Physician
35451
KY
207P00000X
Emergency Medicine Physician
01061798A
IN
207Q00000X
Family Medicine Physician
35451
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000664846
ANTHEM - NICC
KY
01
—
115372
SIHO - NICC
KY
05
—
200192420
—
IN
05
—
7100063510
—
KY
Enumeration date
06/23/2006
Last updated
05/22/2020
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