Provider Demographics
NPI:1972598951
Name:UNISON, JOHN E (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:UNISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1100 SOUTHFIELD DR
Mailing Address - Street 2:SUITE 1370
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4498
Mailing Address - Country:US
Mailing Address - Phone:317-837-5571
Mailing Address - Fax:317-837-5580
Practice Address - Street 1:1100 SOUTHFIELD DR
Practice Address - Street 2:SUITE 1220
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-4498
Practice Address - Country:US
Practice Address - Phone:317-838-3443
Practice Address - Fax:317-838-3444
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2021-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01044012A208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200184770AMedicaid
IN354590MMedicare PIN
IN200184770AMedicaid