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General NPI Number Information
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NPI Number | 1215900311
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Entity Type | Individual
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Provider Name | JAMES OU JIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 621 MEMORIAL DR STE 100
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City | SOUTH BEND
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State | IN
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Zip | 46601-1063
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Country | US
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Telephone | 574-647-1100
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Fax | 574-647-3148
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Provider Business Mailing Address
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Address Line | PO BOX 2968
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City | ELKHART
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State | IN
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Zip | 46515-2968
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Country | US
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Telephone | 574-296-3307
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Fax | 574-296-3328
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 01061466A
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License Number State | IN
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