| NPI | 1568618841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL A WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2080P0206X Pediatrics Pediatric Gastroenterology |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2017-08-10 |