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General NPI Number Information
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NPI Number | 1023148541
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Entity Type | Organization
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Legal Business Name | BEECH GROVE URGENT CARE,INC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 01/31/2011
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Provider Practice Location Address
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Address Line | 4902 E THOMPSON RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-1905
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Country | US
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Telephone | 317-786-1888
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Fax | 317-786-1889
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Provider Business Mailing Address
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Address Line | 4902 E THOMPSON RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-1905
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Country | US
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Telephone | 317-786-1888
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Fax | 317-786-1889
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Authorized Official
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Title or Position | DIRECTOR
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Name | HOUMAN KIANI
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Credential | M.D
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Telephone | 317-786-1888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 01042881
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License Number State | IN
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