Provider Demographics
NPI:1538115498
Name:BRIGHT, JONATHAN D (DC)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:D
Last Name:BRIGHT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 N PERRY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-9025
Mailing Address - Country:US
Mailing Address - Phone:317-839-3900
Mailing Address - Fax:317-838-5452
Practice Address - Street 1:144 N PERRY RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-9025
Practice Address - Country:US
Practice Address - Phone:317-839-3900
Practice Address - Fax:317-838-5452
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002183A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200517790Medicaid