Reisman, John David

Reisman, John David is an individual health care provider with primary practice located at 2600 Greenbush St , Lafayette IN 47904-2479. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Reisman, John David can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
2600 Greenbush St Lafayette IN 47904-2479
Phone: (765) 448-8000
Fax: (765) 448-7619
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 01040939A Indiana

Profile Details

NPI number 1295704427
LBN Legal business name Reisman, John David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Feb 19th, 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 1295704427 NPPES
Indiana Other 000000196959 ANTHEM PROVIDER NUMBER
Indiana Other 10825818 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 100095530 ANTHEM PROVIDER NUMBER
Indiana Other 9038973 ANTHEM PROVIDER NUMBER
Indiana MEDICAID RE17626034 ANTHEM PROVIDER NUMBER

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