Individual
JERRY L HOUSE
Active
Individual
JERRY L HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01025675A
IN
207YX0901X
Otology & Neurotology Physician
Primary
01025675A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000078907
ANTHEM BS
IN
Enumeration date
10/03/2006
Last updated
09/11/2025
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