Healthcare Provider Details

I. General information

NPI: 1952844292
Provider Name (Legal Business Name): OURHEALTH PHYSICIANS GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 VIRGINIA AVE SUITE 1-1200
INDIANAPOLIS IN
46204-3709
US

IV. Provider business mailing address

10 W MARKET ST STE 2900
INDIANAPOLIS IN
46204-2964
US

V. Phone/Fax

Practice location:
  • Phone: 317-559-2055
  • Fax:
Mailing address:
  • Phone: 866-434-3255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERRY LAYMAN
Title or Position: CORPORATE MEDICAL OFFICER
Credential: MD
Phone: 317-727-8698