Dr Jon Joseph Stanich, DC | |
5674 Caito Dr, Suite 110, Indianapolis, IN 46226-1375 | |
(317) 823-7000 | |
Not Available |
Full Name | Dr Jon Joseph Stanich |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 5674 Caito Dr, Indianapolis, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326125634 | NPI | - | NPPES |
100119420 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 08001077 (Indiana) | Primary |
Provider Name | Dr Jon J Stanich Pc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1023292646 PECOS PAC ID: 2466614532 Enrollment ID: O20120507000606 |
Mailing Address | Practice Location Address |
---|---|
Dr Jon Joseph Stanich, DC Po Box 36365, Indianapolis, IN 46236-0365 Ph: (317) 823-7000 | Dr Jon Joseph Stanich, DC 5674 Caito Dr, Suite 110, Indianapolis, IN 46226-1375 Ph: (317) 823-7000 |
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