Healthcare Provider Details

I. General information

NPI: 1720225394
Provider Name (Legal Business Name): ORTHOPAEDICS-INDIANAPOLIS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2009
Last Update Date: 03/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13914 STATE ROAD 238 E SUITE 301
FISHERS IN
46037-5508
US

IV. Provider business mailing address

8450 NORTHWEST BLVD.
INDIANAPOLIS IN
46278-1381
US

V. Phone/Fax

Practice location:
  • Phone: 317-415-9095
  • Fax: 317-415-9096
Mailing address:
  • Phone: 317-802-2000
  • Fax: 317-802-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateIN

VIII. Authorized Official

Name: ANTHONY GIOIA
Title or Position: CFO
Credential:
Phone: 317-802-2042