Healthcare Provider Details

I. General information

NPI: 1972598886
Provider Name (Legal Business Name): SOUTHERN INDIANA IMAGING CONSULTANTS P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 WASHINGTON AVE
EVANSVILLE IN
47750-0001
US

IV. Provider business mailing address

PO BOX 138
EVANSVILLE IN
47701-0138
US

V. Phone/Fax

Practice location:
  • Phone: 812-485-4415
  • Fax: 812-471-6650
Mailing address:
  • Phone: 812-471-1591
  • Fax: 812-471-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS E SCHULTHEIS
Title or Position: PRESIDENT
Credential: MD
Phone: 812-471-1591