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JEFFREY J QUACKENBUSH, MD – NPI #1639151921
Radiation Oncology

NPI Profile for Dr JEFFREY J QUACKENBUSH in VALPARAISO, IN.

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Contact Information

JEFFREY J QUACKENBUSH, MD
54 ROOSEVELT RD
VALPARAISO, IN  46383-5845
 Phone: 219-462-8246
 Fax: 219-462-7902
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Radiation Oncology

 2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

NPI Profile & details for JEFFREY J QUACKENBUSH · (Male)

NPI # 1639151921
Status Active
Credentials MD
Entity Individual
Enumeration date 11/14/2005
Last updated 07/22/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01055750A
  • IN Medicaid 200371010A
  • IN Other 000000228984 ANTHEMBCBS
Hospital affiliation(s)
  • FRANCISCAN ST ANTHONY HEALTH - CROWN POINT - (Acute Care)
    1201 S MAIN ST
    CROWN POINT, IN 46307
  • INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL - (Acute Care)
    1007 LINCOLNWAY
    LA PORTE, IN 46350
  • PORTER VALPARAISO HOSPITAL - (Acute Care)
    85 EAST US HWY 6
    VALPARAISO, IN 46383
  • ST MARY MEDICAL CENTER INC - (Acute Care)
    1500 S LAKE PARK AVE
    HOBART, IN 46342
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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