| NPI | 1528603750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN H PARK CEO 317-580-6303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 207N00000X Dermatology | |
| 207R00000X Internal Medicine | |
| 207W00000X Ophthalmology | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 207V00000X Obstetrics & Gynecology | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine | |
| 207ZC0006X Pathology, Clinical Pathology | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208800000X Urology | |
| 213E00000X Podiatrist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2019-11-12 |