Provider Demographics
NPI:1558391664
Name:MEANS, IRA K (MD)
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:K
Last Name:MEANS
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 1:9997 LAKEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-9560
Mailing Address - Country:US
Mailing Address - Phone:317-344-2162
Mailing Address - Fax:
Practice Address - Street 1:1434 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1947
Practice Address - Country:US
Practice Address - Phone:765-966-5527
Practice Address - Fax:765-966-5527
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01049232A207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN00000082698OtherANTHEM
IN351265355OtherTAX ID
IN200190250Medicaid
IN200190250OtherMANAGED HEALTH SERVICES
IN000000190039OtherBLUESHIELDREIDHOSP-EKG
OH2179495Medicaid
OH2179495Medicaid
IN351265355OtherTAX ID
IN200190250Medicaid
INBM5968853OtherDEA #
IN370014002Medicare PIN