Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 01072457A | IN |
NPI | 1073724548 |
---|---|
Provider Name | Jennifer Lynn Bayer |
First Address | Crown Point, IN 46307-2710 |
Second Address | Crown Point, IN 46307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 27/11/2018 |