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General NPI Number Information
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NPI Number | 1699561779
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Entity Type | Organization
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Legal Business Name | SIMPLICITY HEALTH INDIANA
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 110 E MARKET ST
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City | NEW ALBANY
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State | IN
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Zip | 47150-3410
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Country | US
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Telephone | 502-445-7957
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Fax |
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Provider Business Mailing Address
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Address Line | 110 E MARKET ST
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City | NEW ALBANY
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State | IN
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Zip | 47150-3410
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Country | US
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Telephone | 502-200-7043
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Fax | 502-273-1502
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | RAUL THOMAS
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Credential |
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Telephone | 502-208-4070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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