Healthcare Provider Details

I. General information

NPI: 1881086320
Provider Name (Legal Business Name): INDIANA OUTPATIENT SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2015
Last Update Date: 06/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E VIRGINIA ST
EVANSVILLE IN
47711-5645
US

IV. Provider business mailing address

950 E VIRGINIA ST
EVANSVILLE IN
47711-5645
US

V. Phone/Fax

Practice location:
  • Phone: 855-345-9764
  • Fax:
Mailing address:
  • Phone: 855-345-9764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: EDDIE STONE
Title or Position: PRESIDENT
Credential: MD
Phone: 214-712-2815