Healthcare Provider Details

I. General information

NPI: 1174534887
Provider Name (Legal Business Name): ORTHOPAEDIC SURGICAL CARE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 NORTH MAIN STREET
RUSHVILLE IN
46173
US

IV. Provider business mailing address

PO BOX 246
CONNERSVILLE IN
47331
US

V. Phone/Fax

Practice location:
  • Phone: 765-932-5788
  • Fax: 765-827-7972
Mailing address:
  • Phone: 765-827-6724
  • Fax: 765-827-7972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number01055711A
License Number StateIN

VIII. Authorized Official

Name: DR. WILLIAM G MCDONALD III
Title or Position: ORTHOPAEDIC SURGEON
Credential: MD
Phone: 765-827-6724