# INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INDIANA UNIVERSITY HEALTH BLOOMINGTON INC
- **Other names:** Gosport Family Practice
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003074972
- **Legal business name:** INDIANA UNIVERSITY HEALTH BLOOMINGTON INC
- **Authorized official:** MR. MARLON B FISHEL (ADMINISTRATION, IU HEALTH SIP)
- **Authorized official phone:** (812) 353-5866

## Contact information

- **Practice address:** 7 E MAIN ST, GOSPORT, IN 47433-7034
- **Practice address phone:** (812) 879-4222
- **Practice address fax:** (812) 879-4834
- **Mailing address:** PO BOX 1329, BLOOMINGTON, IN 47402-1329
- **Mailing address phone:** (812) 879-4222
- **Mailing address fax:** (812) 879-4834

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | IN | Yes |

## Other

- **Enumeration date:** 05/28/2008
- **Last updated:** 07/27/2022