Provider Demographics
NPI:1235323601
Name:JAMES E MONEYHUN MD MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JAMES E MONEYHUN MD MEDICAL CORPORATION
Other - Org Name:JAMES E MONEYHUN MD
Other - Org Type:Other Name
Authorized Official - Title/Position:FAMILY DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MONEYHUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-643-6669
Mailing Address - Street 1:2009 BROWN ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016
Mailing Address - Country:US
Mailing Address - Phone:765-643-6669
Mailing Address - Fax:765-643-6660
Practice Address - Street 1:2009 BROWN ST
Practice Address - Street 2:SUITE 8
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016
Practice Address - Country:US
Practice Address - Phone:765-643-6669
Practice Address - Fax:765-643-6660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01018373207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN502920AMedicare PIN
INE05588Medicare UPIN