Individual
JASON W EVERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7910 E WASHINGTON ST, SUITE 200, INDIANAPOLIS, IN 46219-6803
(317) 355-7171
(317) 355-9022
Mailing address
6626 E. 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2790
(317) 355-7199
(317) 355-9022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003712A
IN
207Q00000X
Family Medicine Physician
11013878A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201014320
—
IN
01
—
P01347702
MEDICARE RR
IN
Enumeration date
04/02/2008
Last updated
11/18/2020
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