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General NPI Number Information
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NPI Number | 1649333881
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Entity Type | Organization
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Legal Business Name | INDIANA ORTHOPAEDIC CENTER
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 30 W RAMPART ST SUITE 160
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City | SHELBYVILLE
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State | IN
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Zip | 46176-8846
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Country | US
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Telephone | 317-588-2663
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Fax | 317-392-1446
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Provider Business Mailing Address
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Address Line | 7930 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46250
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Country | US
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Telephone | 317-588-2663
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Fax | 317-588-2727
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | DONNA C SANFORD
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Credential |
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Telephone | 317-863-2180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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