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General NPI Number Information
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NPI Number | 1619310042
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Entity Type | Organization
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Legal Business Name | MERIDIAN PAIN GROUP
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Dates
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Enumeration Date | 04/16/2013
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 69 E GARNER RD 300
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City | BROWNSBURG
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State | IN
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Zip | 46112-7698
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Country | US
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Telephone | 317-550-3999
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Fax | 888-588-4403
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Provider Business Mailing Address
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Address Line | 69 E GARNER RD 300
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City | BROWNSBURG
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State | IN
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Zip | 46112-7698
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Country | US
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Telephone | 317-550-3999
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Fax | 888-588-4403
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY HOWARD WRIGHT
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Credential | M.D.
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Telephone | 317-550-3999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 01027589A
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License Number State | IN
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