Provider Demographics
NPI:1316117864
Name:BRUMMETT, JAMIE R (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:R
Last Name:BRUMMETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1100 REID PKWY
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-983-3127
Mailing Address - Fax:765-983-3219
Practice Address - Street 1:1100 REID PKWY
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1157
Practice Address - Country:US
Practice Address - Phone:765-983-3144
Practice Address - Fax:765-983-3038
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01064042A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200939460Medicaid
IN000001235622OtherANTHEM
OH0052854Medicaid