=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811386436
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MONTGOMERY COUNTY AUDITOR
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2015
-----------------------------------------------------
Last Update Date | 11/12/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 110 W SOUTH BLVD
-----------------------------------------------------
City | CRAWFORDSVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47933-3351
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-364-6440
-----------------------------------------------------
Fax | 765-361-3239
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 110 W SOUTH BLVD
-----------------------------------------------------
City | CRAWFORDSVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47933-3351
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-364-6440
-----------------------------------------------------
Fax | 765-361-3239
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HEALTH OFFICER
-----------------------------------------------------
Name | DR. CARL BRUCE HOWLAND
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 765-364-6440
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------