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General NPI Number Information
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NPI Number | 1043356520
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Entity Type | Organization
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Legal Business Name | SOUTHERN INDIANA PHYSICIANS FOR WOMEN
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/05/2013
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Provider Practice Location Address
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Address Line | 1010 W 2ND ST
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City | BLOOMINGTON
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State | IN
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Zip | 47403-2217
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Country | US
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Telephone | 812-334-3955
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Fax | 812-334-5792
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Provider Business Mailing Address
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Address Line | 1010 W 2ND ST
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City | BLOOMINGTON
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State | IN
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Zip | 47403-2217
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Country | US
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Telephone | 812-334-3955
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Fax | 812-334-5792
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Authorized Official
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Title or Position | OWNER
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Name | DR. LISA MARIE WEILER
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Credential | M.D.
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Telephone | 812-334-3955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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