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NPI Code Detail

MEDICARE: DR. SUSAN K KINDIG MD

MEDICARE: DR. SUSAN K KINDIG MD
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
1207V00000XObstetrics & Gynecology Physician01043649AIN
2207RG0300XGeriatric Medicine (Internal Medicine) Physician01043649AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1160039345OTHERRAILROAD

General Provider Information

NPI Number : 1760459713
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN K KINDIG MD
Provider Business Mailing Address
First Line : 8780 PURDUE RD
Second Line : STE 7
City : INDIANAPOLIS
State : IN
Zip : 46268-6129
Country : US
Telephone Number : 317-471-8701
Fax Number : 317-471-8702
Provider Business Practice Location Address
First Line : 8780 PURDUE RD
Second Line : STE 7
City : INDIANAPOLIS
State : IN
Zip : 46268-6129
Country : US
Telephone Number : 317-471-8701
Fax Number : 317-471-8702
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 09/30/2011

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