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General NPI Number Information
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NPI Number | 1124849260
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Entity Type | Organization
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Legal Business Name | UNION ASSOCIATED PHYSICIANS CLINIC, LLC
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 3401 S 4TH ST
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City | TERRE HAUTE
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State | IN
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Zip | 47802-5501
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Country | US
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Telephone | 812-232-9596
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Fax |
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Provider Business Mailing Address
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Address Line | 1606 N 7TH ST
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City | TERRE HAUTE
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State | IN
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Zip | 47804-2706
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Country | US
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Telephone | 812-238-4989
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | STEVE HOLMAN
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Credential |
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Telephone | 812-238-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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