Healthcare Provider Details

I. General information

NPI: 1043225790
Provider Name (Legal Business Name): ZIONSVILLE OB/GYN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 PARKWAY DR
ZIONSVILLE IN
46077-1953
US

IV. Provider business mailing address

1275 PARKWAY DR
ZIONSVILLE IN
46077-1953
US

V. Phone/Fax

Practice location:
  • Phone: 317-873-8900
  • Fax: 317-873-2655
Mailing address:
  • Phone: 317-873-8900
  • Fax: 317-873-2655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BETTY RANEY
Title or Position: PRESIDENT
Credential:
Phone: 317-873-8900