| NPI | 1619929098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA K MILLER Director Of Billing 765-446-5286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IN 207K00000X) |
| 207Q00000X Family Medicine (Licence: IN 207Z00000X) | |
| 207R00000X Internal Medicine (Licence: IN 207R00000X) | |
| 207V00000X Obstetrics & Gynecology (Licence: IN 207V00000X) | |
| 207VG0400X Obstetrics & Gynecology Gynecology (Licence: IN 207VG0400X) | |
| 207W00000X Ophthalmology (Licence: IN 207W0000X) | |
| 207Y00000X Otolaryngology (Licence: IN 207Y00000X) | |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: IN 207YS0123X) | |
| 208000000X Pediatrics (Licence: IN 208000000X) | |
| 208200000X Plastic Surgery (Licence: IN 208200000X) | |
| 2085R0001X Radiology Radiation Oncology (Licence: IN 2085R0001X) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IN 2085R0202X) | |
| 208800000X Urology (Licence: IN 208800000X) | |
| 363L00000X Nurse Practitioner (Licence: IN 363L00000X) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2019-08-16 |