Healthcare Provider Details

I. General information

NPI: 1518068527
Provider Name (Legal Business Name): PHYSICIANS PRACTICE ORGANIZATION D/B/A NORTHSIDE FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 MIDDLE RD
COLUMBUS IN
47203-4427
US

IV. Provider business mailing address

3201 MIDDLE RD
COLUMBUS IN
47203-4427
US

V. Phone/Fax

Practice location:
  • Phone: 812-372-4956
  • Fax: 812-372-4958
Mailing address:
  • Phone: 812-372-4956
  • Fax: 812-372-4958

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: DR. TERESA L LOVINS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 812-372-4956