Individual
DR. JASON MARTIN CONAUGHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
(812) 477-1558
Mailing address
415 CROSSLAKE DR STE C, EVANSVILLE, IN 47715-8263
(812) 471-1591
(812) 471-6650
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01081103A
IN
207XS0117X
Orthopaedic Surgery of the Spine Physician
01081103A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500623245
—
OR
01
—
P00890807
RAIL ROAD MEDICARE
OR
01
—
P01007268
RAIL ROAD MEDICARE
OR
Enumeration date
06/02/2006
Last updated
03/22/2022
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