| NPI | 1104827633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J. PHILLIPS Director Of Revenue Cycle 765-349-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 2086S0129X Surgery, Vascular Surgery | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2012-05-09 |