| NPI | 1811788862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2025-05-16 |
| Last Update Date | 2025-05-16 |