Healthcare Provider Details

I. General information

NPI: 1598068017
Provider Name (Legal Business Name): INDIANA EMERGENCY PROFESSIONALS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2010
Last Update Date: 02/17/2020
Certification Date: 02/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 WILSON CREEK RD
LAWRENCEBURG IN
47025-2751
US

IV. Provider business mailing address

265 BROOKVIEW CENTRE WAY STE 400
KNOXVILLE TN
37919
US

V. Phone/Fax

Practice location:
  • Phone: 812-537-1010
  • Fax:
Mailing address:
  • Phone: 440-887-4718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN J MURTAUGH
Title or Position: CFO
Credential:
Phone: 856-686-4359