Healthcare Provider Details

I. General information

NPI: 1427783414
Provider Name (Legal Business Name): REGIONS MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 JOLIET ST
DYER IN
46311-1705
US

IV. Provider business mailing address

8829 HILLSIDE DR
SAINT JOHN IN
46373-8736
US

V. Phone/Fax

Practice location:
  • Phone: 219-865-2141
  • Fax:
Mailing address:
  • Phone: 219-512-0012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ERIC CULP
Title or Position: PRESIDENT
Credential: DO
Phone: 219-512-0012