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NPI Code Detail

MEDICARE: DR. JENNIFER MARIE NOTTAGE MD

MEDICARE: DR. JENNIFER MARIE NOTTAGE MD
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
1207W00000XOphthalmology PhysicianD0064859MD
2207WX0120XCornea and External Diseases Specialist Physician01082642AIN

General Provider Information

NPI Number : 1588688741
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER MARIE NOTTAGE MD
Provider Business Mailing Address
First Line : 10300 N ILLINOIS ST
Second Line :
City : CARMEL
State : IN
Zip : 46290-1166
Country : US
Telephone Number : 317-817-1765
Fax Number : 317-817-1767
Provider Business Practice Location Address
First Line : 10300 N ILLINOIS ST
Second Line :
City : CARMEL
State : IN
Zip : 46290-1166
Country : US
Telephone Number : 317-817-1765
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 04/08/2025

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