Healthcare Provider Details

I. General information

NPI: 1255409413
Provider Name (Legal Business Name): MERIDIAN HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12772 HAMILTON CROSSING BOULEVARD
CARMEL IN
46032
US

IV. Provider business mailing address

12772 HAMILTON CROSSING BOULEVARD
CARMEL IN
46032
US

V. Phone/Fax

Practice location:
  • Phone: 317-814-1000
  • Fax: 317-814-1015
Mailing address:
  • Phone: 317-814-1000
  • Fax: 317-814-1015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY H WRIGHT
Title or Position: OFFICER
Credential: M.D.
Phone: 317-814-1000