Provider Demographics
NPI:1255685772
Name:LINCOLN, JARRON J (DO)
Entity Type:Individual
Prefix:
First Name:JARRON
Middle Name:J
Last Name:LINCOLN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30 W RAMPART ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-8846
Mailing Address - Country:US
Mailing Address - Phone:317-398-0121
Mailing Address - Fax:317-398-1851
Practice Address - Street 1:2451 INTELLIPLEX DR STE 260
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-8581
Practice Address - Country:US
Practice Address - Phone:317-398-0121
Practice Address - Fax:317-398-1851
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005845A207Q00000X
IN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine