MEDICARE: JOHN L GEORGE 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	208600000X	Surgery Physician	01022172	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01457041	OTHER	IN	RAIL ROAD PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000648389	OTHER	IN	BCBS

General Provider Information

NPI Number	:	1649362757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN L GEORGE MD

Provider Business Mailing Address
First Line	:	6626 E 75TH ST
Second Line	:	STE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3520 GUION RD
Second Line	:	SUITE 301
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-1692
Country	:	US
Telephone Number	:	317-924-4009
Fax Number	:	317-926-8410

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	01/18/2026

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