Groothuis, Jeffrey S

Groothuis, Jeffrey S is an individual health care provider with primary practice located at 2030 W Boulevard , Kokomo IN 46902-6079. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Groothuis, Jeffrey S can be contacted via phone (765) 454-0200.

Contact Information

Primary practice address
2030 W Boulevard Kokomo IN 46902-6079
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 01045118A Indiana

Profile Details

NPI number 1255307880
LBN Legal business name Groothuis, Jeffrey S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Sep 22nd, 2022 - about 2 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 1255307880 NPPES
Indiana MEDICAID 200100090

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