Provider Demographics
NPI:1740452291
Name:SHOOK, JONATHAN B (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:B
Last Name:SHOOK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8450 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-1381
Mailing Address - Country:US
Mailing Address - Phone:317-802-2000
Mailing Address - Fax:317-802-2170
Practice Address - Street 1:13430 N MERIDIAN ST STE 367
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1484
Practice Address - Country:US
Practice Address - Phone:317-575-2700
Practice Address - Fax:317-575-2713
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2024-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01065236207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200908900Medicaid
IN037170L1Medicare PIN