Provider Demographics
NPI:1194808170
Name:JAMESON, BILLIE JN (MD)
Entity type:Individual
Prefix:DR
First Name:BILLIE
Middle Name:JN
Last Name:JAMESON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3231 N MERIDIAN ST
Mailing Address - Street 2:500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-5848
Mailing Address - Country:US
Mailing Address - Phone:317-920-0007
Mailing Address - Fax:317-920-0388
Practice Address - Street 1:3231 N MERIDIAN ST
Practice Address - Street 2:500
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-5848
Practice Address - Country:US
Practice Address - Phone:317-920-0007
Practice Address - Fax:317-920-0388
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01027530208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100066000Medicaid
IN100066000Medicaid