Agricola, Jeffrey D

Agricola, Jeffrey D is an individual health care provider with primary practice located at 277 E Carmel Dr Ste D, Carmel IN 46032-2609. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Agricola, Jeffrey D can be contacted via phone (317) 846-4111.

Contact Information

Primary practice address
277 E Carmel Dr Ste D Carmel IN 46032-2609
Phone: (317) 846-4111
Fax: (317) 846-1767
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 07000947A Indiana

Profile Details

NPI number 1154327740
LBN Legal business name Agricola, Jeffrey D
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2005
Last updated Apr 15th, 2013 - about 11 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 1154327740 NPPES
Indiana MEDICAID 200409540

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