Healthcare Provider Details

I. General information

NPI: 1528111978
Provider Name (Legal Business Name): PHYSICIANS PRACTICE ORGANIZATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 08/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 17TH ST
COLUMBUS IN
47201-5351
US

IV. Provider business mailing address

2400 17TH ST
COLUMBUS IN
47201-5351
US

V. Phone/Fax

Practice location:
  • Phone: 812-379-4441
  • Fax: 812-348-7497
Mailing address:
  • Phone: 812-379-4441
  • Fax: 812-348-7497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 5
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