| NPI | 1053592568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL N PAYNE Authorized Rep 317-235-8825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2007-11-27 |