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General NPI Number Information
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NPI Number | 1568782373
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Entity Type | Organization
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Legal Business Name | INDIANA UNIVERSITY HEALTH BALL MEMORIAL PHYSICIANS, INC.
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 205 N TILLOTSON AVE SUITE 201B
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City | MUNCIE
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State | IN
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Zip | 47304-3996
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Country | US
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Telephone | 765-281-4599
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Fax | 765-751-2335
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE ATTN: CAROL BOYD
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone | 317-963-0413
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OFFICER
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Name | JANET L VANGETS
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Credential |
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Telephone | 765-751-5404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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