Provider Demographics
NPI:1366443400
Name:PIKE, JAMES D (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:PIKE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7911 MICHIGAN RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1915
Mailing Address - Country:US
Mailing Address - Phone:317-956-6288
Mailing Address - Fax:317-956-6289
Practice Address - Street 1:7911 MICHIGAN RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1915
Practice Address - Country:US
Practice Address - Phone:317-956-6288
Practice Address - Fax:317-956-6289
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02000970A207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000505183OtherBC/BS PIN
DF5450OtherRAILROAD MEDICARE GROUP
P00374166OtherRAILROAD MEDICARE PIN
IN000000505183OtherBCBS PIN
IN200856130Medicaid
IN100465960AMedicaid
IN000000505183OtherBCBS PIN
IN100465960AMedicaid
INF41045Medicare UPIN