Healthcare Provider Details

I. General information

NPI: 1134981541
Provider Name (Legal Business Name): UNION ASSOCIATED PHYSICIANS CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4525 S SPRINGHILL JCT
TERRE HAUTE IN
47802-4563
US

IV. Provider business mailing address

221 S 6TH ST
TERRE HAUTE IN
47807-4214
US

V. Phone/Fax

Practice location:
  • Phone: 812-234-6053
  • Fax:
Mailing address:
  • Phone: 812-232-0564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVE HOLMAN
Title or Position: CEO
Credential:
Phone: 812-238-7000