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General NPI Number Information
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NPI Number | 1235389297
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Entity Type | Organization
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Legal Business Name | INDIANA UNIVERSITY SCHOOL OF MEDICINE, DEPARTMENT OF PATHOLOGY AND LAB
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Dates
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Enumeration Date | 09/26/2008
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Last Update Date | 09/26/2008
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Provider Practice Location Address
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Address Line | 635 BARNHILL DR # MS 128
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5126
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Country | US
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Telephone | 317-274-1738
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Fax |
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Provider Business Mailing Address
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Address Line | 635 BARNHILL DR # MS 128
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5126
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Country | US
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Telephone | 317-274-1738
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | JOHN N EBLE
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Credential | M.D.
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Telephone | 317-274-1738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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