=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699949313
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JEFFREY R GINTHER MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2008
-----------------------------------------------------
Last Update Date | 04/23/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 493 WESTFIELD RD STE A
-----------------------------------------------------
City | NOBLESVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46060-1304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-770-4100
-----------------------------------------------------
Fax | 317-770-4105
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 110 LAKEVIEW DR #5
-----------------------------------------------------
City | NOBLESVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46060-1325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-770-4100
-----------------------------------------------------
Fax | 317-770-4105
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. ELIZABETH GINTHER
-----------------------------------------------------
Credential | BA, MS
-----------------------------------------------------
Telephone | 317-770-4100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | 1044640
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------