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General NPI Number Information
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NPI Number | 1205189420
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Entity Type | Organization
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Legal Business Name | UNIVERSITY SURGEONS, INC
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 545 BARNHILL DR EH 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5112
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Country | US
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Telephone | 317-274-3086
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Fax |
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Provider Business Mailing Address
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Address Line | 545 BARNHILL DR EH 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SECTION DIRECTOR
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Name | DR. DON JAY SELZER
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Credential | M.D.
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Telephone | 317-274-3086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71004150A
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License Number State | IN
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