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General NPI Number Information
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NPI Number | 1437361516
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Entity Type | Organization
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Legal Business Name | ONCOLOGY HEMATOLOGY ASSOCIATES OF SOUTHWEST INDIANA
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3801 BELLEMEADE SUITE 110
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City | EVANSVILLE
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State | IN
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Zip | 47714
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Country | US
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Telephone | 812-471-1200
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Fax | 812-962-0777
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Provider Business Mailing Address
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Address Line | 3801 BELLEMEADE SUITE 110
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City | EVANSVILLE
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State | NE
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Zip | 47714
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Country | US
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Telephone | 812-962-0771
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Fax | 812-962-0777
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | SUSAN WAGNER
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Credential |
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Telephone | 812-962-0771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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