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General NPI Number Information
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NPI Number | 1952979288
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Entity Type | Organization
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Legal Business Name | IVISIT DOC INC
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Dates
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Enumeration Date | 06/14/2021
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 7345 WOODLAND DR STE 1
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City | INDIANAPOLIS
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State | IN
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Zip | 46278-1737
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Country | US
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Telephone | 317-762-4025
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Fax | 317-759-4003
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Provider Business Mailing Address
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Address Line | 7345 WOODLAND DR STE 1
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City | INDIANAPOLIS
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State | IN
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Zip | 46278-1737
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Country | US
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Telephone | 877-843-2351
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Fax | 317-981-6716
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Authorized Official
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Title or Position | VICE PRESIDENT OF TECHNOLOGY
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Name | MR. LEO OBRIQUE
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Credential |
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Telephone | 317-561-9125
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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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