Provider Demographics
NPI:1487639415
Name:GARBER, JOHN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:GARBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 N LEBANON ST STE 305
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-8622
Mailing Address - Country:US
Mailing Address - Phone:765-485-8852
Mailing Address - Fax:765-485-8669
Practice Address - Street 1:2705 N LEBANON ST STE 220
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-8622
Practice Address - Country:US
Practice Address - Phone:765-485-8883
Practice Address - Fax:765-485-8795
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01028587A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200540210Medicaid
IN200540210 AMedicaid
IN2009056OtherCIGNA HMO
INE15107Medicare UPIN
IN2009056OtherCIGNA PPO AND OPEN ACCESS
IN1043498405Medicare NSC
IN000000374698OtherANTHEM
IN232520AOtherMEDICARE