Provider Demographics
NPI:1982806980
Name:CLOUSE, JOLENE RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOLENE
Middle Name:RENEE
Last Name:CLOUSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2401 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-3428
Mailing Address - Country:US
Mailing Address - Phone:765-282-3139
Mailing Address - Fax:
Practice Address - Street 1:2401 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-3428
Practice Address - Country:US
Practice Address - Phone:765-741-1007
Practice Address - Fax:765-747-4466
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01062614A207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology