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NPI Code Detail

MEDICARE: JOSEPHSON WALLACK MUNSHOWER NEUROLOGY PC

MEDICARE: JOSEPHSON WALLACK MUNSHOWER NEUROLOGY PC
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
12084N0400XNeurology PhysicianIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CJ9849OTHERMEDICARE RR

Other Identifiers

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

General Provider Information

NPI Number : 1396832556
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSEPHSON WALLACK MUNSHOWER NEUROLOGY PC
Provider Business Mailing Address
First Line : 6983 HILLSDALE CT
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2054
Country : US
Telephone Number : 317-308-2800
Fax Number : 317-576-6311
Provider Business Practice Location Address
First Line : 2330 S DIXON RD STE 325
Second Line :
City : KOKOMO
State : IN
Zip : 46902-6430
Country : US
Telephone Number : 317-308-2800
Fax Number : 765-865-3935
Authorized Official
Title or Position : CFO/CIO
Name : SUSAN MATTOX
Credential :
Telephone Number : 317-849-8350
Provider Enumeration Date : 10/09/2006
Last Update Date : 05/09/2025

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Directions to “JOSEPHSON WALLACK MUNSHOWER NEUROLOGY PC ” Practice Location

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