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General NPI Number Information
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NPI Number | 1124102918
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Entity Type | Individual
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Provider Name | JAY ALLEN GADDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 8326 NAAB RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1920
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Country | US
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Telephone | 317-871-0000
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Fax | 317-871-0010
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Provider Business Mailing Address
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Address Line | 8326 NAAB RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1920
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Country | US
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Telephone | 317-871-0000
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Fax | 317-871-0010
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 01062387A
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License Number State | IN
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