Healthcare Provider Details

I. General information

NPI: 1801845086
Provider Name (Legal Business Name): RESPIRATORY & CRITICAL CARE CONSULTANTS P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 05/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 W 86TH ST SUITE 111
INDIANAPOLIS IN
46260-1930
US

IV. Provider business mailing address

2010 W 86TH ST SUITE 111
INDIANAPOLIS IN
46260-1930
US

V. Phone/Fax

Practice location:
  • Phone: 317-872-5591
  • Fax: 317-876-9273
Mailing address:
  • Phone: 317-872-5591
  • Fax: 317-876-9273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number50003225A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number50003225A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number50003225A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number50003225A
License Number StateIN

VIII. Authorized Official

Name: MARY A. DUNCAN
Title or Position: CFO/BUSINESS MANAGER
Credential:
Phone: 317-872-5591