Healthcare Provider Details

I. General information

NPI: 1396903902
Provider Name (Legal Business Name): JONATHON SCOTT CLINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: J SCOTT CLINE MD

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E MAIN ST
DANVILLE IN
46122-1948
US

IV. Provider business mailing address

1100 SOUTHFIELD DR SUITE 1370
PLAINFIELD IN
46168-4498
US

V. Phone/Fax

Practice location:
  • Phone: 317-745-4451
  • Fax: 317-718-6740
Mailing address:
  • Phone: 317-837-5571
  • Fax: 317-837-5580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number01066475A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: