Qualls, Jefferson

Qualls, Jefferson is an individual health care provider with primary practice located at 301 Henry St , North Vernon IN 47265-1030. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Qualls, Jefferson can be contacted via phone (317) 695-1241.

Contact Information

Primary practice address
301 Henry St North Vernon IN 47265-1030
Phone: (317) 695-1241
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01037759 Indiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01037759A Indiana

Profile Details

NPI number 1992882419
LBN Legal business name Qualls, Jefferson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Mar 10th, 2022 - about 4 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 1992882419 NPPES
Indiana MEDICAID 100194060

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