JASON D RUSS

INDIANAPOLIS, IN
NPI1457679417
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: IN  01071327A)
Additional Taxonomies207R00000X Internal Medicine
(Licence: IN  11015387A)
Enumeration Date2010-05-13
Last Update Date2021-02-03
Business Address
JASON D RUSS MD
1800 N CAPITOL AVE NP E-140
INDIANAPOLIS, IN 46202-1218
Phone number: 317-962-2894
Mailing Address
JASON D RUSS MD
250 N SHADELAND AVE STE 130 - PROVIDER ENROLLMENT
INDIANAPOLIS, IN 46219-4959
Phone number: