Healthcare Provider Details
I. General information
NPI: 1316964802
Provider Name (Legal Business Name): PROFESSIONAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3266 N MERIDIAN ST SUITE 501
INDIANAPOLIS IN
46208-5846
US
IV. Provider business mailing address
3266 N MERIDIAN ST SUITE 501
INDIANAPOLIS IN
46208-5846
US
V. Phone/Fax
- Phone: 317-924-8315
- Fax:
- Phone: 317-924-8315
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHY
BARNETT
Title or Position: ASSIST EXECUTIVE DIRECTOR
Credential:
Phone: 317-924-8208