MEDICARE: HEMATOLOGY ONCOLOGY OF INDIANA PC

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
1	207RH0003X	Hematology & Oncology Physician		IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447216171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEMATOLOGY ONCOLOGY OF INDIANA PC

Provider Business Mailing Address
First Line	:	8301 HARCOURT RD
Second Line	:	STE 200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2081
Country	:	US
Telephone Number	:	317-415-6600
Fax Number	:	317-415-6666

Provider Business Practice Location Address
First Line	:	8301 HARCOURT RD
Second Line	:	STE 200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2081
Country	:	US
Telephone Number	:	317-415-6600
Fax Number	:	317-415-6666

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MS. SHANNON L ROBBINS
Credential	:
Telephone Number	:	317-415-6639

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	12/14/2011

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