| NPI | 1023107869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P FOUTY CFO/Authorized Representitive 812-232-0564 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RA0201X Internal Medicine Allergy & Immunology |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2008-07-29 |