NPI | 1861961138 |
---|---|
Entity Type | Organization |
Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
Organization Subpart ? | No |
Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
Additional Taxonomies | 363A00000X Physician Assistant |
363L00000X Nurse Practitioner | |
207Q00000X Family Medicine | |
Enumeration Date | 2018-11-16 |
Last Update Date | 2020-10-27 |