Jetmore, David Louis

Jetmore, David Louis is an individual health care provider with primary practice located at 1434 Chester Blvd. , Richmond IN 47374-1919. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Jetmore, David Louis can be contacted via phone (765) 966-1600.

Contact Information

Primary practice address
1434 Chester Blvd. Richmond IN 47374-1919
Phone: (765) 966-1600
Fax: (765) 962-9641
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 01023140A Indiana
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 01023140A Indiana

Profile Details

NPI number 1215939467
LBN Legal business name Jetmore, David Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated May 14th, 2021 - 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 1215939467 NPPES
Indiana Other 000000841132 ANTHEM
Indiana MEDICAID 0544192 ANTHEM
Indiana MEDICAID 100256310 ANTHEM

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