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NPI Code Detail

MEDICARE: OURHEALTH PHYSICIANS GROUP, LLC

MEDICARE: OURHEALTH PHYSICIANS GROUP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1386190254
Entity Type Code : Organization
Provider Name (Legal Business Name) : OURHEALTH PHYSICIANS GROUP, LLC
Provider Business Mailing Address
First Line : 1 AMERICAN SQ
Second Line : 2610
City : INDIANAPOLIS
State : IN
Zip : 46282-0020
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5630 W 86TH ST
Second Line : SUITE 150
City : INDIANAPOLIS
State : IN
Zip : 46278-2017
Country : US
Telephone Number : 317-559-2055
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JEFFERY WELLS
Credential :
Telephone Number : 317-559-2055
Provider Enumeration Date : 08/30/2016
Last Update Date : 08/30/2016

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Directions to “OURHEALTH PHYSICIANS GROUP, LLC ” Practice Location

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