Search › Indiana › 172A00000X
Michael Jackson
NPI 1639818735 · on the registry since 2022 · sole proprietor
Practice
- Address
- 10816 Washington Bay Dr
Fishers, IN 46037 - Phone
- (317) 801-0551
Registry record
- Primary taxonomy
- 172A00000X
172A00000X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-09-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana