| NPI | 1144314097 | 
|---|---|
| Doing Business As | INDY SOUTHSIDE SURGICAL | 
| Entity Type | Organization | 
| Authorized Contact | DENA L PETTY Manager 317-865-4800 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 208600000X Surgery | 
| Enumeration Date | 2006-10-03 | 
| Last Update Date | 2020-08-22 |