Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 01033474A | IN |
N | 207XS0106X | Orthopaedic Hand Surgeon | 01033474A | IN |
N | 2086S0129X | Vascular Surgeon | 01033474 | IN |
NPI | 1225047244 |
---|---|
Provider Name | Dr. James Joseph Creighton JR. |
First Address | Indianapolis, IN 46260-2046 |
Second Address | Indianapolis, IN 46260-2046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 27/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000082982 | ANTHEM HEALTH PLAN (01) | |
0269983001 | CIGNA (01) | |
100087050 | (05) | IN |
D43825 | (02) |