Provider Demographics
NPI:1538131115
Name:ORCUTT, JEFFREY DAVID (AUD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DAVID
Last Name:ORCUTT
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18000 RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-8329
Mailing Address - Country:US
Mailing Address - Phone:317-774-7811
Mailing Address - Fax:317-776-4557
Practice Address - Street 1:18000 RIVER AVE
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-8329
Practice Address - Country:US
Practice Address - Phone:317-773-6579
Practice Address - Fax:317-776-4557
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002319A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000324103OtherBLUE CROSS
IN200452900Medicaid
IN000000324102OtherBLUE CROSS
IN000000352573OtherBLUE CROSS
IN000000314709OtherBLUE CROSS
IN000000324101OtherBLUE CROSS
IN000000324104OtherBLUE CROSS
IN000000324100OtherBLUE CROSS
INP01027067OtherMEDICARE RR PTAN
IN000000352573OtherBLUE CROSS
INP01027067OtherMEDICARE RR PTAN
IN200452900Medicaid
INM400054513Medicare PIN
IN000000324102OtherBLUE CROSS
IN145030EMedicare ID - Type Unspecified
IN827850EMedicare ID - Type Unspecified