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Jon Blake Chadwell, MD
Otolaryngology/Facial Plastic Surgery Physician in South Bend, Indiana
NPI 1255380903

Jon Blake Chadwell is a Otolaryngology/Facial Plastic Surgery Physician based in South Bend, IN and is specialized in Otolaryngology/Facial Plastic Surgery. Jon Blake Chadwell practices in South Bend, IN and has the professional credentials of MD. The NPI Number for Jon Blake Chadwell is 1255380903 and holds a License No. 01061815A (Indiana).

The current practice location address for Jon Blake Chadwell is 6301 University Commons, South Bend, IN and can be reached out via phone at 574-232-4800 and via fax at 574-280-4810.

Location: 6301 University Commons, South Bend, IN, 46635-1571
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255380903
Provider Name
Jon Blake Chadwell
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
6301 University Commons, South Bend, IN, 46635-1571
Phone Number
574-232-4800
Fax Number
574-280-4810
Provider Enumeration Date
05/09/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01061815A 01 IN INDIANA LICENSE
000000485851 01 IN ANTHEM PIN
200523340A 05 IN
institution
Provider Business Practice Location Address Details
Address
6301 University Commons
City
South Bend
State
Indiana
Zip
46635-1571
Phone Number
574-232-4800
Fax Number
574-280-4810
person
Provider Business Mailing Address Details
Address
6301 University Commons
City
South Bend
State
Indiana
Zip
46635-1571
Phone Number
574-232-4800
Fax Number
574-280-4810
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Otolaryngology
Speciality
Otolaryngology/Facial Plastic Surgery
Taxonomy
207YX0905X
License No.
01061815A (Indiana)
Definition
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
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