| NPI | 1962537415 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LINDA S. MOORE Office Manager 812-425-3362 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01033267) | 
| Enumeration Date | 2007-02-23 | 
| Last Update Date | 2020-08-22 |