Individual
JORDAN ALEXANDER HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
535 BARNHILL DR, RT 041, INDIANAPOLIS, IN 46202-5116
(317) 944-2524
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01078019A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300003530
—
IN
01
—
719710011
MEDICARE
IN
Enumeration date
05/08/2012
Last updated
09/20/2022
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