Healthcare Provider Details
I. General information
NPI: 1285684407
Provider Name (Legal Business Name): IU ANESTHESIOLOGY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2006
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
550 UNIVERSITY BLVD
INDIANAPOLIS IN
46202-5149
US
IV. Provider business mailing address
250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US
V. Phone/Fax
- Phone: 317-274-0275
- Fax: 800-731-0699
- Phone: 888-484-3258
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LC0200X |
| Taxonomy | Critical Care Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | IN |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | IN |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP3000X |
| Taxonomy | Pediatric Anesthesiology Physician |
| License Number | |
| License Number State | IN |
VIII. Authorized Official
Name: DR.
DAVID
C.
ADAMS
Title or Position: DIRECTOR-MANAGING EMPLOYEE
Credential: M.D.
Phone: 317-274-0275