| NPI | 1366221228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIA FISHER Credentialing 812-962-7894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical | |
| 363L00000X Nurse Practitioner | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| 367H00000X Anesthesiologist Assistant | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 207L00000X Anesthesiology | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2024-02-20 |