MEDICARE: JOSE D PINON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	01063828A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00886783	OTHER	IN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205852795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE D PINON MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:	STE 130 - PROVIDER ENROLLMENT
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11725 N ILLINOIS ST
Second Line	:	STE 465
City	:	CARMEL
State	:	IN
Zip	:	46032-3010
Country	:	US
Telephone Number	:	317-688-5840
Fax Number	:	317-688-5841

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	10/24/2013

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Directions to “ JOSE D PINON MD” Practice Location

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