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General NPI Number Information
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NPI Number | 1235236456
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Entity Type | Organization
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Legal Business Name | INDIANA MEDICAL SPECIALISTS, INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 455 E HOSPITAL LN
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4245
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Country | US
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Telephone | 812-238-1521
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Fax | 812-232-0341
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Provider Business Mailing Address
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Address Line | 455 E HOSPITAL LN P.O. BOX 2240
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4245
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Country | US
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Telephone | 812-238-1521
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Fax | 812-232-0341
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Authorized Official
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Title or Position | CFO
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Name | GINGER GIORDANO
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Credential |
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Telephone | 812-514-7217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01049692
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01049698
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01029981
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License Number State | IN
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