| NPI | 1720256068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL R ESGUERRA Owner 812-847-8711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01039089) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: IN 01039089) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: IN 01039089) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: IN 01039089) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: IN 01039089) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: IN 01039089) | |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2020-12-29 |