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General NPI Number Information
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NPI Number | 1295072924
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Entity Type | Organization
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Legal Business Name | CENTRAL INDIANA PODIATRY, PC
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 13421 OLD MERIDIAN ST STE 202
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City | CARMEL
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State | IN
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Zip | 46032-1411
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Country | US
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Telephone | 317-931-0664
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Fax | 888-510-7211
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Provider Business Mailing Address
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Address Line | 6299 GUION RD STE C
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-2530
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Country | US
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Telephone | 317-931-0664
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Fax | 317-927-0924
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | SARAH KERANS
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Credential |
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Telephone | 317-931-0664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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