| NPI | 1508085754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWIGHT LEROY BLACKBURN Medical Director 812-283-4844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |