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NPI Code Detail

MEDICARE: INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS, INC

MEDICARE: INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR1300XRural Health Clinic/Center

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CI4187OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366600231
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS, INC
Provider Business Mailing Address
First Line : PO BOX 1329
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47402-1329
Country : US
Telephone Number : 812-829-2237
Fax Number : 812-829-6342
Provider Business Practice Location Address
First Line : 9 N CRANE AVE
Second Line :
City : SPENCER
State : IN
Zip : 47460-1507
Country : US
Telephone Number : 812-829-2237
Fax Number : 812-829-6342
Authorized Official
Title or Position : ADMINISTRATION, IU HEALTH SIP
Name : MARLON B FISHEL
Credential :
Telephone Number : 812-353-5866
Provider Enumeration Date : 05/28/2008
Last Update Date : 02/22/2022

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Directions to “INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS, INC ” Practice Location

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