| NPI | 1003612946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma | |
| 213E00000X Podiatrist | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 363A00000X Physician Assistant | |
| 207XS0106X Orthopaedic Surgery, Hand Surgery | |
| Enumeration Date | 2025-02-21 |
| Last Update Date | 2026-06-16 |