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General NPI Number Information
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NPI Number | 1235871724
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Entity Type | Organization
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Legal Business Name | COMMUNITY PHYSICIANS OF INDIANA INC
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 11787 LANTERN RD STE 200
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City | FISHERS
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State | IN
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Zip | 46038-2801
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Country | US
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Telephone | 317-957-9140
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Fax | 317-957-9141
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Provider Business Mailing Address
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Address Line | 11787 LANTERN RD STE 200
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City | FISHERS
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State | IN
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Zip | 46038-2801
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Country | US
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Telephone | 317-957-9140
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Fax | 317-957-9141
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Authorized Official
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Title or Position | CFO
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Name | JEFFREY KIRKHAM
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Credential |
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Telephone | 317-497-6169
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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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