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General NPI Number Information
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NPI Number | 1285841502
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Entity Type | Organization
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Legal Business Name | DECATUR VEIN CLINIC HOBART, PC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 5043 E LINCOLN HWY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5912
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Country | US
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Telephone | 219-942-1717
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Fax | 800-591-3117
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Provider Business Mailing Address
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Address Line | 8925 N MERIDIAN ST SUITE 100
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-2386
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Country | US
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Telephone | 866-218-4060
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Fax | 800-591-3117
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | THOMAS M WHITTEN
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Credential | MD
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Telephone | 317-218-2807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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