Healthcare Provider Details

I. General information

NPI: 1497846828
Provider Name (Legal Business Name): JAMES JING ZHANG M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9302 N MERIDIAN ST SUITE 101
INDIANAPOLIS IN
46260-1841
US

IV. Provider business mailing address

6330 CASTLEPLACE DR SUITE 130
INDIANAPOLIS IN
46250-1902
US

V. Phone/Fax

Practice location:
  • Phone: 317-570-7900
  • Fax: 317-570-2288
Mailing address:
  • Phone: 317-570-7900
  • Fax: 317-570-2288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number01057326A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number01057326A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number01057326A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: