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General NPI Number Information
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NPI Number | 1679182190
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Entity Type | Organization
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Legal Business Name | INDIANA UNIVERSITY HEALTH PAOLI INC
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Dates
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Enumeration Date | 07/30/2020
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 560 W. LONGEST STREET
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City | PAOLI
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State | IN
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Zip | 47454-9670
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Country | US
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Telephone | 812-723-7440
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Fax |
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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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 |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MICHAEL L CRAIG
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Credential |
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Telephone | 812-353-9171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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