| Organization Name: | JON D. MISCH, D.O.,P.C. |
| NPI Number: | 1972716082 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JON D. MISCH (PRESIDENT) |
| Mailing Address: | 13963 Morse St Cedar Lake |
| State: | IN US |
| Postal Code: | 463039639 |
| Phone Number: | 2193745555 |
| Fax Number: | 2193746669 |
| NPI Enumeration Date: | 05/07/2007 |
| NPI Last Update Date: | 05/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 04/08/2010 |
| NPI Reactivation Date: | 05/07/2010 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 02000900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |