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General NPI Number Information
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NPI Number | 1194997965
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Entity Type | Organization
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Legal Business Name | INDIANAPOLIS ENDOSCOPY CENTER LLP
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 04/20/2009
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Provider Practice Location Address
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Address Line | 8315 E 56TH ST SUITE 100
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City | INDIANAPOLIS
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State | IN
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Zip | 46216-1023
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Country | US
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Telephone | 317-621-1800
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Fax | 317-621-3232
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Provider Business Mailing Address
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Address Line | 8315 E 56TH ST SUITE 100
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City | INDIANAPOLIS
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State | IN
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Zip | 46216-1023
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Country | US
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Telephone | 317-621-1800
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Fax | 317-621-3232
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. KATHY JEAN ANDERSON
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Credential | RN
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Telephone | 317-621-1850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 080078861
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License Number State | IN
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