MEDICARE: JONATHAN FOX NOEL 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
1	208600000X	Surgery Physician	01046983A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982606885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN FOX NOEL MD

Provider Business Mailing Address
First Line	:	505 W HOMER ST STE 102
Second Line	:
City	:	SALEM
State	:	IN
Zip	:	47167-1698
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 W HOMER ST STE 102
Second Line	:
City	:	SALEM
State	:	IN
Zip	:	47167-1698
Country	:	US
Telephone Number	:	812-883-1708
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	08/04/2022

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Directions to “ JONATHAN FOX NOEL MD” Practice Location

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