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General NPI Number Information
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NPI Number | 1518761857
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Entity Type | Individual
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Provider Name | JEAN PIERRE PRISO RT(R)
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Gender | Male
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 3905 VINCENNES RD STE 303
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-3030
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Country | US
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Telephone | 317-827-5058
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Fax | 317-471-3508
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Provider Business Mailing Address
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Address Line | 10849 MEADOW LAKE DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46229-3513
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Country | US
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Telephone | 317-797-1133
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Fax |
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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 | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | XT021811
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License Number State | IN
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