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General NPI Number Information
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NPI Number | 1568071710
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Entity Type | Organization
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Legal Business Name | IVX HEALTH OF INDIANA PC
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 07/23/2020
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Provider Practice Location Address
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Address Line | 9510 N MERIDIAN ST STE D
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1333
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Country | US
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Telephone | 317-210-9005
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Fax |
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Provider Business Mailing Address
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Address Line | 13344 METCALF AVE
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City | OVERLAND PARK
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State | KS
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Zip | 66213-2804
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Country | US
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Telephone | 913-948-2020
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Fax | 844-435-3188
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Authorized Official
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Title or Position | CFO
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Name | WILLIAM SEIBELS
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Credential |
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Telephone | 615-610-3727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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