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NPI Code Detail

MEDICARE: ASSOCIATED PHYSICIANS & SURGEONS CLINIC, LLC

MEDICARE: ASSOCIATED PHYSICIANS & SURGEONS CLINIC, 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
1207Y00000XOtolaryngology Physician
2207RH0003XHematology & Oncology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10176835OTHERUS DEPT OF LABOR

General Provider Information

NPI Number : 1568552271
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASSOCIATED PHYSICIANS & SURGEONS CLINIC, LLC
Provider Business Mailing Address
First Line : 221 S 6TH ST
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47807-4214
Country : US
Telephone Number : 812-232-0564
Fax Number : 812-242-3848
Provider Business Practice Location Address
First Line : 2229 MARY SHERMAN DR
Second Line :
City : SULLIVAN
State : IN
Zip : 47882-7633
Country : US
Telephone Number : 812-232-0564
Fax Number : 812-242-3848
Authorized Official
Title or Position : CFO/AUTHORIZED REPRESENTATIVE
Name : MICHAEL P FOUTY
Credential :
Telephone Number : 812-232-0564
Provider Enumeration Date : 10/13/2006
Last Update Date : 04/20/2008

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Directions to “ASSOCIATED PHYSICIANS & SURGEONS CLINIC, LLC ” Practice Location

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