Provider Demographics
NPI:1831230366
Name:JAMES M PEARCE MD PC
Entity type:Organization
Organization Name:JAMES M PEARCE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-873-5837
Mailing Address - Street 1:PO BOX 6280
Mailing Address - Street 2:DEPARTMENT 0032
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-6280
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1710 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-1033
Practice Address - Country:US
Practice Address - Phone:765-362-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100083120Medicaid
300136464OtherRAILROAD MEDICARE
300136464OtherRAILROAD MEDICARE