Healthcare Provider Details

I. General information

NPI: 1215125224
Provider Name (Legal Business Name): TREE CITY MEDICAL PARTNERS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 N MICHIGAN AVE
GREENSBURG IN
47240-1487
US

IV. Provider business mailing address

955 N MICHIGAN AVE
GREENSBURG IN
47240-1487
US

V. Phone/Fax

Practice location:
  • Phone: 812-663-7277
  • Fax: 812-662-7307
Mailing address:
  • Phone: 812-663-7277
  • Fax: 812-662-7307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateIN

VIII. Authorized Official

Name: DR. MARY R MCCULLOUGH
Title or Position: MD
Credential: MD
Phone: 812-663-7277