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General NPI Number Information
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NPI Number | 1356605299
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Entity Type | Individual
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Provider Name | JAY JUN-HONG JIN MD
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Gender | Male
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 705 RILEY HOSPITAL DR # 4270
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5109
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Country | US
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Telephone | 317-948-7208
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Fax | 317-944-7245
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Provider Business Mailing Address
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Address Line | PO BOX 1026
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-1026
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Country | US
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Telephone | 317-777-6435
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Fax | 317-777-6644
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 01080635A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01080635A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number | 01080635A
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License Number State | IN
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