Provider Demographics
NPI:1811949175
Name:STEARLEY, JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:STEARLEY
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 1:3 E MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:GOSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:47402
Mailing Address - Country:US
Mailing Address - Phone:812-879-4222
Mailing Address - Fax:812-879-4834
Practice Address - Street 1:3 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:GOSPORT
Practice Address - State:IN
Practice Address - Zip Code:47402
Practice Address - Country:US
Practice Address - Phone:812-879-4222
Practice Address - Fax:812-879-4834
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01028362207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100195250AMedicaid
IN100195250AMedicaid
INB29237Medicare UPIN
IN090540Medicare PIN