NPI | 1225715832 |
---|---|
Entity Type | Organization |
Authorized Contact | CHERYL ANNETTE WATHEN Secretary Treasurer 812-450-3296 |
Organization Subpart ? | No |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery |
207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck | |
363L00000X Nurse Practitioner | |
208600000X Surgery | |
363A00000X Physician Assistant | |
Enumeration Date | 2023-07-05 |
Last Update Date | 2025-09-24 |