Provider Demographics
NPI:1851576912
Name:JAIN, ARUN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUN
Middle Name:
Last Name:JAIN
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 1:1901 LAFAYETTE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-1098
Mailing Address - Country:US
Mailing Address - Phone:765-361-8586
Mailing Address - Fax:765-364-8641
Practice Address - Street 1:1901 LAFAYETTE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-1098
Practice Address - Country:US
Practice Address - Phone:765-361-8586
Practice Address - Fax:765-364-8641
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01047257A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN212430AMedicare PIN