1841331378 NPI number — JAMES M PEARCE M.D.

Table of content: JAMES M PEARCE M.D. (NPI 1841331378)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841331378 NPI number — JAMES M PEARCE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEARCE
Provider First Name:
JAMES
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841331378
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6280
Provider Second Line Business Mailing Address:
DEPARTMENT 0032
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46206-6280
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1710 LAFAYETTE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CRAWFORDSVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47933-1033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-362-2800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  01029529A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000243442 . This is a "ANTHEM" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 115825 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 383655450 . This is a "CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 300136464 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100083120 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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