Provider Demographics
NPI:1902852221
Name:SIGG, JOE P
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:P
Last Name:SIGG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 N POST RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4246
Mailing Address - Country:US
Mailing Address - Phone:317-897-8970
Mailing Address - Fax:
Practice Address - Street 1:1201 N POST RD
Practice Address - Street 2:SUITE 6
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4246
Practice Address - Country:US
Practice Address - Phone:317-897-8970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120066481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN12006648OtherSTATE LICENSE
IN100048520AMedicaid