Healthcare Provider Details

I. General information

NPI: 1831531672
Provider Name (Legal Business Name): JASPER INPATIENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W 9TH ST
JASPER IN
47546-2514
US

IV. Provider business mailing address

100 WITMER RD STE. 220
HORSHAM PA
19044-2291
US

V. Phone/Fax

Practice location:
  • Phone: 812-996-0323
  • Fax: 812-996-0321
Mailing address:
  • Phone: 215-442-5031
  • Fax: 215-957-2875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: EDDIE STONE
Title or Position: OWNER
Credential: M.D.
Phone: 800-526-9252