| Indiana University Health Jay, Inc. | |
|
500 W Votaw St Portland IN 47371-1322 | |
| (260) 726-8822 | |
| Not Available |
| Full Name | Indiana University Health Jay, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 500 W Votaw St, Portland, Indiana |
| Authorized Official Name and Position | Jonathan W Vanator (CFO) |
| Authorized Official Contact | 7657412891 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indiana University Health Jay, Inc. 250 N Shadeland Ave Indianapolis IN 46219-4959 Ph: (877) 668-5621 | Indiana University Health Jay, Inc. 500 W Votaw St Portland IN 47371-1322 Ph: (260) 726-8822 |
| NPI Number | 1639940976 |
|---|---|
| Provider Enumeration Date | 01/15/2024 |
| Last Update Date | 01/15/2024 |
| Medicare PECOS PAC ID | 1355602483 |
|---|---|
| Medicare Enrollment ID | O20240315002247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639940976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Thomas D Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316901200 PECOS PAC ID: 1850374836 Enrollment ID: I20040610000980 |
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