Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 01069531A | IN |
NPI | 1003077082 |
---|---|
Provider Name | John Thomas Gripe |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-1228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2008 |
Last Update Date | 19/07/2021 |