Healthcare Provider Details

I. General information

NPI: 1972848588
Provider Name (Legal Business Name): PHYSICIANS PRACTICE ORGANIZATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2012
Last Update Date: 12/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 18TH ST STE 130
COLUMBUS IN
47201-5388
US

IV. Provider business mailing address

2325 18TH ST STE 130
COLUMBUS IN
47201-5388
US

V. Phone/Fax

Practice location:
  • Phone: 812-379-2020
  • Fax: 812-378-8272
Mailing address:
  • Phone: 812-379-2020
  • Fax: 812-378-8272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN R ALESSI
Title or Position: PRESIDENTY
Credential: D.O.
Phone: 812-988-2223