Healthcare Provider Details
I. General information
NPI: 1164038618
Provider Name (Legal Business Name): UNION ASSOCIATED PHYSICIANS CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/21/2020
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 S MAIN ST STE 200
CLINTON IN
47842-2261
US
IV. Provider business mailing address
1606 N 7TH ST
TERRE HAUTE IN
47804-2706
US
V. Phone/Fax
- Phone: 812-232-0564
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVE
HOLMAN
Title or Position: CEO
Credential:
Phone: 812-238-7606