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NPI Code Detail

MEDICARE: DR. GABRIEL JOHN GENZ JERKINS MD

MEDICARE: DR. GABRIEL JOHN GENZ JERKINS 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
12084P0800XPsychiatry Physician01098555AIN

General Provider Information

NPI Number : 1801452156
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GABRIEL JOHN GENZ JERKINS MD
Provider Business Mailing Address
First Line : 1481 W 10TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2803
Country : US
Telephone Number : 317-554-0000
Fax Number :
Provider Business Practice Location Address
First Line : 1481 W 10TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2803
Country : US
Telephone Number : 317-554-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2019
Last Update Date : 05/21/2026

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