Provider Demographics
NPI:1699949313
Name:JEFFREY R GINTHER MD PC
Entity type:Organization
Organization Name:JEFFREY R GINTHER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GINTHER
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MS
Authorized Official - Phone:317-770-4100
Mailing Address - Street 1:110 LAKEVIEW DR #5
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1325
Mailing Address - Country:US
Mailing Address - Phone:317-770-4100
Mailing Address - Fax:317-770-4105
Practice Address - Street 1:493 WESTFIELD RD STE A
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1304
Practice Address - Country:US
Practice Address - Phone:317-770-4100
Practice Address - Fax:317-770-4105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1044640207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CJ5229OtherMEDICARE RAIL ROAD
IN189090Medicare PIN