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General NPI Number Information
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NPI Number | 1699872150
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Entity Type | Organization
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Legal Business Name | EXPRESSCARE OF SOUTHERN INDIANA
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Dates
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Enumeration Date | 09/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3897 CHARLESTOWN RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-9562
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Country | US
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Telephone | 812-542-1901
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Fax | 812-542-1904
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Provider Business Mailing Address
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Address Line | 3897 CHARLESTOWN RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-9562
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Country | US
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Telephone | 812-542-1901
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Fax | 812-542-1904
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Authorized Official
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Title or Position | OWNER
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Name | DAVID BRUNCK
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Credential | PA-C
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Telephone | 812-542-1901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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