Provider Demographics
NPI:1780652958
Name:CRONER, JAMES THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:THOMAS
Last Name:CRONER
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 1:1200 W WHITE RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-4988
Mailing Address - Country:US
Mailing Address - Phone:877-668-5621
Mailing Address - Fax:
Practice Address - Street 1:550 S HOKE AVE
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IN
Practice Address - Zip Code:46041-2664
Practice Address - Country:US
Practice Address - Phone:765-448-8000
Practice Address - Fax:765-659-2577
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01043957A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000297258OtherANTHEM PROVIDER NUMBER
IN10781195OtherCAQH NUMBER
IN200126970Medicaid
IN9072067OtherPHCS PID NUMBER
IN10781195OtherCAQH NUMBER
ING55101Medicare UPIN
IN200126970Medicaid
IN142080PPMedicare PIN