NPI | 1124787973 |
---|---|
Entity Type | Organization |
Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
Organization Subpart ? | No |
Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363L00000X Nurse Practitioner | |
Enumeration Date | 2021-12-09 |
Last Update Date | 2021-12-09 |