Provider Demographics
NPI:1396725693
Name:JIMENEZ, CLAUDIE H (MD)
Entity type:Individual
Prefix:DR
First Name:CLAUDIE
Middle Name:H
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8102 CLEARVISTA PARKWAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1661
Mailing Address - Country:US
Mailing Address - Phone:317-849-8222
Mailing Address - Fax:317-849-1455
Practice Address - Street 1:101 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:IN
Practice Address - Zip Code:46001-2017
Practice Address - Country:US
Practice Address - Phone:765-233-0903
Practice Address - Fax:765-705-2141
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY238182207P00000X
OH35.1478732083A0300X
IN01077090A2083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG52244Medicare UPIN