Provider Demographics
NPI:1083678585
Name:EHRET, JASON CHAD (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:CHAD
Last Name:EHRET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6626 E 75TH STREET
Mailing Address - Street 2:STE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-621-7561
Mailing Address - Fax:317-355-6096
Practice Address - Street 1:7250 CLEARVISTA DRIVE
Practice Address - Street 2:STE 227
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-5600
Practice Address - Country:US
Practice Address - Phone:317-621-5719
Practice Address - Fax:317-621-6086
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01060267A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200524130Medicaid
INM400022728Medicare PIN
INI35828Medicare UPIN