Provider Demographics
NPI:1649763244
Name:MERSHON, JOHN LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEE
Last Name:MERSHON
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 1:3023 WOODSHORE CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-3643
Mailing Address - Country:US
Mailing Address - Phone:317-432-5534
Mailing Address - Fax:
Practice Address - Street 1:2596 N GIRLS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-2105
Practice Address - Country:US
Practice Address - Phone:317-244-3387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01055667A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology