Healthcare Provider Details

I. General information

NPI: 1477477594
Provider Name (Legal Business Name): INDIANA UNIVERSITY HEALTH BLOOMINGTON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 TEKE BURTON DR
MITCHELL IN
47446-1208
US

IV. Provider business mailing address

105 TEKE BURTON DR
MITCHELL IN
47446-1208
US

V. Phone/Fax

Practice location:
  • Phone: 812-849-3408
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL L CRAIG
Title or Position: VP/CFO
Credential:
Phone: 812-353-9171