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Individual

PHILIP JASON CLAPHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01084363A
IN
207RI0200X
Infectious Disease Physician
Primary
01084363A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11017937A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001422934
ANTHEM PTAN
IN
05
300042320
IN
Enumeration date
06/20/2014
Last updated
03/06/2025
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