MARK J JANICKI (NPI# 1588661409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588661409 |
| Entity Type | Individual |
| Full Name | MARK J JANICKI |
| Credential | MD, FAAN |
| Practice Address |
2705 N Lebanon St Ste 265 Lebanon IN 46052-8621 |
| Mailing Address |
2705 N Lebanon St Ste 305 Lebanon IN 46052-8622 |
| Practice Telephone | 7654858830 |
| Practice Fax Number | 7654858839 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
01032550A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100068000 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6085 Heartland Dr Ste 200, Zionsville, IN 460774433 | 7654858830 | 7654858839 |
| Street Address |
2705 N LEBANON ST STE 265 |
| City | LEBANON |
| State | IN |
| Zip Code | 46052-8621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225324841 | Amanda Jean Stevens-udeze | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2011-06-22 |
| 1790075851 | Zachary Nathan Gordon | Urology | 2705 N Lebanon St Ste 265, Lebanon, IN 46052 | 2011-04-11 |
| 1306167424 | Chad H Meshberger | Psychiatry & Neurology | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2010-06-14 |
| 1376869669 | Kevin Boone | Hospitalist | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2010-04-13 |
| 1598995086 | Adam Anthony Cieciuch | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2009-07-20 |
| 1396905782 | Tehniat Haider | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2008-06-10 |
| 1528226321 | Neha Shardul Gavin | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2008-05-28 |
| 1922169374 | Alex Kor | Podiatrist | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2006-12-12 |
| 1356307003 | Crystal L Jones | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2006-04-21 |
| 1740277466 | Thomas Ray Cartwright | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2005-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316567647 | Meredith England Labrie | Behavioral Analyst | 110 Birchwood Drivve, Lebanon, IN 46052 | 2020-04-16 |
| 1710401492 | Kenzlie Ann Westerfield | Specialist/Technologist | 613 Countryside Drive, Lebanon, IN 46052 | 2017-08-03 |
| 1487040044 | Jenny L Essex | Social Worker | 1614 N. Lebanon St., Integrative Wellness, LLC, Lebanon, IN 46052 | 2015-04-10 |
| 1316177363 | Kathryn Elizabeth Ehrgott | Counselor | 1005 South Lebanon Street, Boone County Services, Lebanon, IN 46052 | 2009-07-23 |
| 1780838557 | Kathleen M Whitaker | Registered Nurse | 209 W North St, Lebanon, IN 46052 | 2008-11-06 |
| 1851551998 | James R Mcafee | General Practice | 1997 Terrace Ln, Lebanon, IN 46052 | 2008-06-12 |
| 1518021773 | Zulfiqar Ali Mirza | Internal Medicine | 2505 N Lebanon St Ste 220, Lebanon, IN 46052 | 2006-12-21 |
| 1316016108 | Russell Allen Lindner | Chiropractor | 3920 North State Road 39, Boone County Chiropractic Office, Lebanon, IN 46052 | 2006-11-07 |
| 1487755781 | Cowan Drugs Inc | Pharmacy | 112 N Lebanon St, Lebanon, IN 46052 | 2006-09-26 |
| 1558463992 | Cowan Drugs Inc | Pharmacy | 1639 N Lebanon St, Lebanon, IN 46052 | 2006-09-05 |
| Find all providers in zip 46052 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558989160 | Ioana Medrea | Psychiatry & Neurology | One Medical Centre Dr, Lebanon, NH 03756-0001 | 2020-07-09 |
| 1396847968 | Donald Gary Kolva | Psychiatry & Neurology | 958 Isabel Dr, Lebanon, PA 17042-7482 | 2006-09-02 |
| 1114376498 | Naveen George | Psychiatry & Neurology | One Medical Center Dr, Lebanon, NH 03756-1000 | 2016-06-08 |
| 1962864967 | Robert Lewis Fuino | Psychiatry & Neurology | 958 Isabel Dr, Lebanon, PA 17042-7482 | 2016-03-28 |
| 1780070060 | Ryan Wilson | Psychiatry & Neurology | 1 Medical Center Dr, Dhmc, Lebanon, NH 03756-1000 | 2015-04-13 |
| 1033514419 | Sahyli Perez Parra | Psychiatry & Neurology | 1 Medical Center Dr, Dhmc Department of Neurology, Lebanon, NH 03756 | 2014-10-28 |
| 1295155117 | George Wesley Culler Iv | Psychiatry & Neurology | One Medical Center Dr, Neurology, Lebanon, NH 03756-0001 | 2014-04-17 |
| 1184060816 | Anthony Laine Green | Psychiatry & Neurology | 1 Medical Center Dr, Lebanon, NH 03756 | 2013-05-21 |
| 1568727535 | Rebecca J Thompson | Psychiatry & Neurology | 1 Medical Dr, Lebanon, NH 03756-1000 | 2012-07-05 |
| 1184910689 | Nathaniel M Robbins | Psychiatry & Neurology | 1 Medical Center Drive, Neurology, Lebanon, NH 03756-0001 | 2011-06-22 |
| Find all providers in LEBANON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.