Provider Demographics
NPI:1376527192
Name:PIERSON, JEFFERY (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:
Last Name:PIERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12188B N MERIDIAN ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4840
Mailing Address - Country:US
Mailing Address - Phone:317-706-2361
Mailing Address - Fax:317-706-2362
Practice Address - Street 1:12188B N MERIDIAN ST
Practice Address - Street 2:SUITE 250
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4840
Practice Address - Country:US
Practice Address - Phone:317-706-2361
Practice Address - Fax:317-706-2362
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039944207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200042105OtherRR MEDICARE
IN2000383002OtherCIGNA
IN4251092OtherAETNA
IN014532OtherSIHO
IN1081975OtherUHC
IN000000207867OtherBCBS
IN014532OtherSIHO
INF24524Medicare UPIN
IN2000383002OtherCIGNA