Healthcare Provider Details

I. General information

NPI: 1477323079
Provider Name (Legal Business Name): OURHEALTH PROFESSIONAL PHYSICIAN GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2024
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14580 GATEWAY RD
CAMBRIDGE CITY IN
47327-9514
US

IV. Provider business mailing address

10 W MARKET ST STE 2900
INDIANAPOLIS IN
46204-2964
US

V. Phone/Fax

Practice location:
  • Phone: 765-478-4446
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TERRY LAYMAN
Title or Position: SVP, CORPORATE MEDICAL OFFICE
Credential: MD
Phone: 317-727-8698