| NPI | 1003612946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| 363L00000X Nurse Practitioner | |
| 363A00000X Physician Assistant | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma | |
| Enumeration Date | 2025-02-21 |
| Last Update Date | 2025-10-30 |