person
Jason R Grove, DPM
Podiatrist in Mishawaka, Indiana
NPI 1609040088

Jason R Grove is a Podiatrist based in South Bend, IN. Jason R Grove practices in Mishawaka, IN and has the professional credentials of DPM. The NPI Number for Jason R Grove is 1609040088 and holds a License No. 36.003447 (Indiana).

The current practice location address for Jason R Grove is 611 E Douglas Rd Ste 101, Mishawaka, IN and can be reached out via phone at 574-335-6800 and via fax at 574-335-0772. You can also correspond with Jason R Grove through the mailing address at 707 CEDAR ST STE 200, SOUTH BEND, IN - 46617-2057 (mailing address contact number: 574-335-8700).

Location: 611 E Douglas Rd Ste 101, Mishawaka, IN, 46617-2057
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Provider Profile Details
NPI Number
1609040088
Provider Name
Jason R Grove
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
611 E Douglas Rd Ste 101, Mishawaka, IN, 46617-2057
Phone Number
574-335-6800
Fax Number
574-335-0772
Provider Enumeration Date
04/17/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000592921 01 IN BCBS BMG SCHWARTZ
000000591890 01 IN BCBS BMG LAPORTE
738460026 01 IN MEDICARE PIN
IN1933041 01 IN MEDICARE PIN
000000591888 01 IN BCBS BMG MAIN STREET
000000592923 01 IN BCBS BMG IRELAND
000000710624 01 IN BCBS BMG BREMEN
P00656770 01 IN RR MEDICARE
000000630279 01 IN BCBS BMG PORTAGE
200912030 05 IN
institution
Provider Business Practice Location Address Details
Address
611 E Douglas Rd Ste 101
City
State
Zip
46545-1464
Phone Number
574-335-6800
Fax Number
574-335-0772
person
Provider Business Mailing Address Details
Address
707 Cedar St Ste 200
City
State
Zip
46617-2057
Phone Number
574-335-8700
Fax Number
574-335-0760
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
License No.
07001058A (Indiana)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
36.003447 (Ohio)
Definition
Definition to come...
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