Provider Demographics
NPI:1871635326
Name:LASKIN, JERROLD ARON (MD)
Entity Type:Individual
Prefix:DR
First Name:JERROLD
Middle Name:ARON
Last Name:LASKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12425 OLD MERIDIAN ST
Mailing Address - Street 2:SUITE B1
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8724
Mailing Address - Country:US
Mailing Address - Phone:317-706-9600
Mailing Address - Fax:317-706-9606
Practice Address - Street 1:12425 OLD MERIDIAN ST
Practice Address - Street 2:SUITE B1
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8724
Practice Address - Country:US
Practice Address - Phone:317-706-9600
Practice Address - Fax:317-706-9606
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01040371208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
INF31449Medicare UPIN
IN317540AMedicare PIN