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NPI Code Detail

MEDICARE: DR. JAMES NICHOLAS TOPOLGUS JR. M.D.

MEDICARE: DR. JAMES NICHOLAS TOPOLGUS JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician01022367AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1544310AOTHERINMEDICARE PTAN

General Provider Information

NPI Number : 1508863945
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES NICHOLAS TOPOLGUS JR. M.D.
Provider Business Mailing Address
First Line : 1419 S SARE RD
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47401-4431
Country : US
Telephone Number : 312-388-8676
Fax Number :
Provider Business Practice Location Address
First Line : 3201 W REDDY WAY
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-4066
Country : US
Telephone Number : 812-825-0756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 03/25/2025

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