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General NPI Number Information
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NPI Number | 1124156237
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Entity Type | Organization
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Legal Business Name | THE BONE AND JOINT CENTER OF SOUTHERN INDIANA P.C.
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 10/05/2007
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Provider Practice Location Address
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Address Line | 2415B MITCHELL RD
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City | BEDFORD
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State | IN
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Zip | 47421-4731
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Country | US
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Telephone | 812-276-1004
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Fax | 812-276-1005
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Provider Business Mailing Address
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Address Line | PO BOX 146
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City | BEDFORD
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State | IN
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Zip | 47421-0146
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Country | US
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Telephone | 812-276-1004
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Fax | 812-276-1005
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES B RICKERT
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Credential | M.D.
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Telephone | 812-276-1004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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