Healthcare Provider Details

I. General information

NPI: 1487658381
Provider Name (Legal Business Name): PHYSICIANS PRACTICE ORGANIZATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 05/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 CENTRAL AVE
COLUMBUS IN
47203
US

IV. Provider business mailing address

4050 CENTRAL AVE
COLUMBUS IN
47203
US

V. Phone/Fax

Practice location:
  • Phone: 812-376-9427
  • Fax:
Mailing address:
  • Phone: 812-376-9427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateIN

VIII. Authorized Official

Name: DR. JOHN R ALESSI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 812-988-2223