Phan, Jennifer

Phan, Jennifer is an individual health care provider with primary practice located at 3113 N Broadway Street , Anderson IN 46012-1261. She recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as her primary health care specialty. Phan, Jennifer can be contacted via phone (765) 298-4660.

Contact Information

Primary practice address
3113 N Broadway Street Anderson IN 46012-1261
Phone: (765) 298-4660
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 11014885A Indiana

Profile Details

NPI number 1861621880
LBN Legal business name Phan, Jennifer
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2009
Last updated Nov 27th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861621880 NPPES
Indiana Other P01723972 RR MEDICARE
Indiana MEDICAID 201110020 RR MEDICARE

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