| Doctor Name: | JACK DAVID MARKIEWICZ |
| NPI Number: | 1003066325 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 01072267A |
| Business Practice Address: | 550 University Blvd Indianapolis, IN - 462025149 |
| Business Phone Number: | 3172789729 |
| Business Fax Number: | |
| Mailing Address: | 1007 Lincolnway, LA PORTE |
| State: | IN |
| Postal Code: | 463503201 |
| Phone Number: | 2193262305 |
| Fax Number: | 2193262605 |
| NPI Enumeration Date: | 09/23/2008 |
| NPI Last Update Date: | 10/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 01072267A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |