Healthcare Provider Details

I. General information

NPI: 1710099106
Provider Name (Legal Business Name): PHYSICIANS PRACTICE ORGANIZATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 WILLOW ST STE B
NASHVILLE IN
47448-7605
US

IV. Provider business mailing address

PO BOX 127
NASHVILLE IN
47448-0127
US

V. Phone/Fax

Practice location:
  • Phone: 812-988-2223
  • Fax: 812-988-3933
Mailing address:
  • Phone: 812-988-2223
  • Fax: 812-988-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateIN

VIII. Authorized Official

Name: JOHN R ALESSI
Title or Position: PRESIDENT
Credential: DO
Phone: 812-988-2223