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General NPI Number Information
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NPI Number | 1194813154
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Entity Type | Organization
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Legal Business Name | SOUTH CENTRAL INDIANA PATHOLOGY, PC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 2400 17TH ST
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City | COLUMBUS
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State | IN
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Zip | 47201-5351
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Country | US
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Telephone | 812-376-5790
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Fax | 812-376-5431
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Provider Business Mailing Address
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Address Line | PO BOX 1329
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City | COLUMBUS
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State | IN
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Zip | 47202-1329
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Country | US
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Telephone | 812-418-0014
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Fax | 812-418-0076
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRET HUBER
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Credential | DO
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Telephone | 812-376-5322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 01036499A
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License Number State | IN
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