MEDICARE: PREMISE HEALTH OF INDIANA MEDICAL, P.C.

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1518385541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMISE HEALTH OF INDIANA MEDICAL, P.C.

Provider Business Mailing Address
First Line	:	5500 MARYLAND WAY STE 120
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4993
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 W JFK DR
Second Line	:
City	:	NORTH VERNON
State	:	IN
Zip	:	47265-6117
Country	:	US
Telephone Number	:	812-346-9441
Fax Number	:	812-346-9493

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JON LEIZMAN
Credential	:	MD
Telephone Number	:	216-479-9063

Provider Enumeration Date	:	04/07/2014
Last Update Date	:	08/25/2022

Similar Medicare Providers

1689829814 — MS. GEORGIA CAMPBELL HALL NP
Practice Location Address:

1301 W JFK DR
NORTH VERNON, IN
47265-6117

Practice Phone: 812-346-9476
Practice Fax: 812-346-9493

1831550094 — SARAH DUMAS
Practice Location Address:

6490 IRON HORSE BLVD
NORTH RICHLAND HILLS, TX
76180-6117

Practice Phone: 469-343-4076
Practice Fax:

1528513876 — BRIDGET HENDERSON
Practice Location Address:

6117 KITAMAYA ST
NORTH LAS VEGAS, NV
89031-1764

Practice Phone: 909-202-6599
Practice Fax:

1073068482 — LISA MITCHELL
Practice Location Address:

6117 KITAMAYA ST
NORTH LAS VEGAS, NV
89031-1764

Practice Phone: 614-500-2923
Practice Fax:

1740830462 — MERVIN KENNETH ALEXANDER JR.
Practice Location Address:

6117 BROCCOLI ST
NORTH LAS VEGAS, NV
89081-6677

Practice Phone: 702-685-3063
Practice Fax:

1457391021 — DR. SCOTT L SLIVKA MD
Practice Location Address:

301 HENRY ST
NORTH VERNON, IN
47265-1030

Practice Phone: 812-352-4300
Practice Fax: 812-352-4301

Directions to “PREMISE HEALTH OF INDIANA MEDICAL, P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.