Provider Demographics
NPI:1689676108
Name:JOVEN, JOHN N (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:N
Last Name:JOVEN
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:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-0129
Mailing Address - Country:US
Mailing Address - Phone:317-468-6270
Mailing Address - Fax:317-468-6268
Practice Address - Street 1:120 W MCKENZIE RD STE H
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-1072
Practice Address - Country:US
Practice Address - Phone:317-462-2335
Practice Address - Fax:317-462-2069
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01045241A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200040530Medicaid
IN0000005243118OtherAETNA PIN#
IN000000223761OtherANTHEM PIN#
IN200311740GMedicaid
IN080191378OtherMEDICARE RAILROAD #
IN000000223761OtherANTHEM PIN#
205110JMedicare Oscar/Certification