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General NPI Number Information
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NPI Number | 1619984556
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Entity Type | Individual
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Provider Name | JEFFREY J NACE MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 11590 N MERIDIAN STREET SUITE 410
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City | CARMEL
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State | IN
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Zip | 46032-6955
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Country | US
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Telephone | 317-688-5580
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Fax | 317-688-5581
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Provider Business Mailing Address
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Address Line | 11590 N MERIDIAN STREET SUITE 410
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City | CARMEL
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State | IN
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Zip | 46032-6955
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Country | US
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Telephone | 317-688-5580
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Fax | 317-688-5581
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 48389
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License Number State | MN
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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 | 01063718A
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License Number State | IN
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