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Contact Information

PREETHAM JETTY, MD
1210 A MEDICAL ARTS BLVD
SUITE 105
ANDERSON, IN46011-3437
 Phone: 765-298-4660
 Fax: 765-298-4926
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PREETHAM JETTY · (Male)

NPI # 1962469510
Status Active
Credentials MD
Entity Individual
Enumeration date 04/27/2006
Last updated 06/11/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01040154A
  • IN Medicaid 100120660
  • IN Other 4218217 AETNA
  • IN Other 000000557249 ANTHEM
  • IN Other 000000586512 ANTHEM
  • IN Other P01214600 RR MEDICARE PTAN
Hospital affiliation(s)
  • COMMUNITY HOSPITAL EAST - (Acute Care)
    1500 N RITTER AVE
    INDIANAPOLIS, IN 46219
  • COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY - (Acute Care)
    1515 N MADISON AVE
    ANDERSON, IN 46011
  • SAINT JOHN'S HEALTH SYSTEM - (Acute Care)
    2015 JACKSON ST
    ANDERSON, IN 46016
  • ST VINCENT MERCY HOSPITAL - (Critical Access)
    1331 S A ST
    ELWOOD, IN 46036
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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