| 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 | 208600000X Surgery |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2025-02-20 |