Provider Demographics
NPI:1952414443
Name:ALBRECHT, JOHN E (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:ALBRECHT
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:PO BOX 1921
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1921
Mailing Address - Country:US
Mailing Address - Phone:317-781-3604
Mailing Address - Fax:317-780-3353
Practice Address - Street 1:70 E MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1393
Practice Address - Country:US
Practice Address - Phone:317-969-7227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01027501A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
115773OtherHEALTHLINK
000000089605OtherANTHEM
5935053OtherAETNA
01367OtherCIGNA
IN100243740Medicaid
5935053OtherAETNA
01367OtherCIGNA
ININ2318006Medicare PIN
IN230650HMedicare PIN
000000089605OtherANTHEM
IN110102714Medicare PIN