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General NPI Number Information
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NPI Number | 1205204203
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH NETWORK
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Dates
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Enumeration Date | 09/08/2015
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 1643 E HANNA AVE STE 108
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-3655
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Country | US
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Telephone | 317-788-3368
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 N RITTER AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-3027
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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 | CFO
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Name | JEFFERY L KIRKHAM
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Credential |
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Telephone | 317-355-5822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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