Healthcare Provider Details

I. General information

NPI: 1619105244
Provider Name (Legal Business Name): COMMUNITY PHYSICIANS OF INDIANA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7240 SHADELAND STATION SUITE 300
INDIANAPOLIS IN
46256-3944
US

IV. Provider business mailing address

7240 SHADELAND STA STE 300
INDIANAPOLIS IN
46256-3944
US

V. Phone/Fax

Practice location:
  • Phone: 317-355-5555
  • Fax:
Mailing address:
  • Phone: 317-355-5555
  • Fax: 317-355-8716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN KUNZER
Title or Position: EVP
Credential: MD
Phone: 317-355-5961