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General NPI Number Information
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NPI Number | 1629637020
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Entity Type | Organization
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Legal Business Name | JOSEPHSON WALLACK MUNSHOWER NEUROLOGY PC
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Dates
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Enumeration Date | 06/10/2019
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 325 WESTFIELD RD STE D
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City | NOBLESVILLE
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State | IN
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Zip | 46060-1496
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Country | US
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Telephone | 765-298-4545
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Fax | 765-298-4945
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Provider Business Mailing Address
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Address Line | 6983 HILLSDALE CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2054
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Country | US
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Telephone | 317-308-2800
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Fax | 317-576-6311
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Authorized Official
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Title or Position | CFO/CIO
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Name | SUSAN MATTOX
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Credential |
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Telephone | 317-308-2828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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