Healthcare Provider Details
I. General information
NPI: 1396566436
Provider Name (Legal Business Name): UNION ASSOCIATED PHYSICIANS CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 A ST NE STE 9
LINTON IN
47441-1612
US
IV. Provider business mailing address
221 S 6TH ST
TERRE HAUTE IN
47807-4214
US
V. Phone/Fax
- Phone: 812-238-2100
- Fax:
- Phone: 812-232-0564
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVE
HOLMAN
Title or Position: CEO
Credential:
Phone: 812-238-7000