Individual
ROGER W HURLBUT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
5026 W US 52, NEW PALESTINE, IN 46163-9770
(317) 861-4838
Mailing address
5026 W US 52, NEW PALESTINE, IN 46163-9770
(317) 861-4838
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
71002460A
IN
363LP2300X
Primary Care Nurse Practitioner
Primary
71002460A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000532575
ANTHEM
IN
05
—
200872580
—
IN
01
—
CA5604
MCR RAILROAD GROUP
IN
01
—
P00631303
RAILROAD MEDICARE
IN
Enumeration date
08/30/2007
Last updated
07/09/2019
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