Provider Demographics
NPI:1083107007
Name:LI, JINGPIN (MD)
Entity Type:Individual
Prefix:
First Name:JINGPIN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2016 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526-5236
Mailing Address - Country:US
Mailing Address - Phone:574-533-7600
Mailing Address - Fax:574-364-7666
Practice Address - Street 1:2016 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-5236
Practice Address - Country:US
Practice Address - Phone:574-533-7600
Practice Address - Fax:574-364-7666
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01086442A207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine