NPI 1083505481

Jacob Austin Shaw, PARAMEDIC

Practitioner Military Health Care Provider Indianapolis, IN

Practice location

Address: 6704 Smithfield Blvd, Indianapolis, IN 46237-9106
Phone: (317) 619-6884
Fax: (317) 619-6884

Registered specialties

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X Licence M5148988 (IN)

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Registry record

NPI: 1083505481
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Jul 2025
Record last updated: 14 Jul 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.