| NPI | 1750254207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS O'CONNOR Executive Medical Director 317-953-6917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 122300000X Dentist |
| 152W00000X Optometrist | |
| Enumeration Date | 2025-09-29 |
| Last Update Date | 2025-09-29 |