Provider Demographics
NPI:1225253487
Name:JIN, XIAOMING (PHD)
Entity type:Individual
Prefix:DR
First Name:XIAOMING
Middle Name:
Last Name:JIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 W 86TH ST STE 355
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-5734
Mailing Address - Country:US
Mailing Address - Phone:317-660-2858
Mailing Address - Fax:
Practice Address - Street 1:3901 W 86TH ST STE 355
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-5734
Practice Address - Country:US
Practice Address - Phone:317-660-2858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10028171100000X
IN84000133A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist