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General NPI Number Information
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NPI Number | 1629699772
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Entity Type | Individual
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Provider Name | JARED BLAKE SALISBURY MD
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Gender | Male
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 550 UNIVERSITY BLVD RM 641
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5149
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Country | US
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Telephone | 317-278-2686
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Fax | 317-278-2650
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Provider Business Mailing Address
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Address Line | 550 UNIVERSITY BLVD RM 641
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5149
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Country | US
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Telephone | 317-278-2686
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Fax | 317-278-2650
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01095404A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD28950
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 34242
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License Number State | NH
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