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General NPI Number Information
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NPI Number | 1487680518
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Entity Type | Organization
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Legal Business Name | UROLOGY OF INDIANA L.L.C.
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 679 E COUNTY LINE RD
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City | GREENWOOD
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State | IN
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Zip | 46143-1049
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Country | US
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Telephone | 317-859-7222
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Fax | 317-859-7220
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Provider Business Mailing Address
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Address Line | 679 E COUNTY LINE RD
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City | GREENWOOD
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State | IN
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Zip | 46143-1049
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Country | US
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Telephone | 317-885-1250
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Fax | 317-859-4268
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Authorized Official
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Title or Position | M.D./ OWNER
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Name | DR. BRADLEY G ORRIS
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Credential | M.D.
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Telephone | 317-859-7222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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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 | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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