Healthcare Provider Details

I. General information

NPI: 1922120609
Provider Name (Legal Business Name): ASSOCIATED PLASTIC SURGEONS OF INDIANA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11455 N MERIDIAN ST 150
CARMEL IN
46032-1624
US

IV. Provider business mailing address

11455 N MERIDIAN ST 150
CARMEL IN
46032-1624
US

V. Phone/Fax

Practice location:
  • Phone: 317-848-0001
  • Fax: 317-848-0002
Mailing address:
  • Phone: 317-848-0001
  • Fax: 317-848-0002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number01041619A
License Number StateIN

VIII. Authorized Official

Name: JANET K TURKLE
Title or Position: OWNER
Credential: MD
Phone: 317-848-0001