Provider Demographics
NPI:1578657813
Name:BRINKRUFF, JAMES D (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:BRINKRUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 E. BOYD AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-2816
Mailing Address - Country:US
Mailing Address - Phone:317-462-5252
Mailing Address - Fax:317-462-8010
Practice Address - Street 1:300 E BOYD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-2834
Practice Address - Country:US
Practice Address - Phone:317-462-5252
Practice Address - Fax:317-462-8010
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01057370207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200161370Medicaid
IN200161370Medicaid
IN151560B2Medicare PIN
IN151560B2Medicare PIN
P00181500Medicare PIN