Provider Demographics
NPI:1649439118
Name:AYON, JAIME (MD)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:AYON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2150 INTELLIPLEX DR STE 134
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-8550
Mailing Address - Country:US
Mailing Address - Phone:317-428-2075
Mailing Address - Fax:317-981-2836
Practice Address - Street 1:2150 INTELLIPLEX DR STE 134
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-8550
Practice Address - Country:US
Practice Address - Phone:317-428-2075
Practice Address - Fax:317-981-2836
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01068575A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200990100Medicaid
INP00894351OtherICCC RAILROAD MEDICARE
INM400021865Medicare PIN
IN200990100Medicaid
INP01054237Medicare PIN