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General NPI Number Information
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NPI Number | 1033697529
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Entity Type | Organization
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Legal Business Name | HOSPITALIST MEDICINE PHYSICIANS OF INDIANA-TCG, LLC
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Dates
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Enumeration Date | 08/06/2018
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 8701 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-7035
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Country | US
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Telephone | 219-738-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 120 BRENTWOOD COMMONS WAY STE 510
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City | BRENTWOOD
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State | TN
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Zip | 37027-2028
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Country | US
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Telephone | 253-682-6040
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Fax |
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Authorized Official
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Title or Position | PAYER ENROLLMENT MANAGER
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Name | LAURA FALL
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Credential |
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Telephone | 253-682-6040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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