Healthcare Provider Details

I. General information

NPI: 1518061191
Provider Name (Legal Business Name): PHYSICIANS PRACTICE ORGANIZATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 DOCTORS PARK DR
COLUMBUS IN
47203-2219
US

IV. Provider business mailing address

1950 DOCTORS PARK DR
COLUMBUS IN
47203-2219
US

V. Phone/Fax

Practice location:
  • Phone: 812-372-8281
  • Fax: 812-372-4525
Mailing address:
  • Phone: 812-372-8281
  • Fax: 812-372-4525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN R ALESSI
Title or Position: PRESIDENT
Credential: DO
Phone: 812-988-2223