Stockrahm, Jon Lee

Stockrahm, Jon Lee is an sole proprietor health care provider with primary practice located at 2800 Poplar Street Ste 19 A, Terre Haute IN 47803-2659. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Stockrahm, Jon Lee can be contacted via phone (812) 235-7252.

Contact Information

Primary practice address
2800 Poplar Street Ste 19 A Terre Haute IN 47803-2659
Fax: (812) 235-7176
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 02002047 Indiana

Profile Details

NPI number 1962409466
LBN Legal business name Stockrahm, Jon Lee
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2005
Last updated Sep 25th, 2023 - about last year

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 1962409466 NPPES
Indiana Other 110232365 RAILROAD MEDICARE
Indiana Other 000000211750 RAILROAD MEDICARE
Indiana MEDICAID 200227720A RAILROAD MEDICARE
Indiana Other 5902718 RAILROAD MEDICARE

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