# AMERICAN HEALTH NETWORK OF INDIANA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AMERICAN HEALTH NETWORK OF INDIANA, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033220017
- **Legal business name:** AMERICAN HEALTH NETWORK OF INDIANA, LLC
- **Authorized official:** BEN H PARK MD (PRESIDENT AND CEO)
- **Authorized official phone:** (317) 580-6307

## Contact information

- **Practice address:** 510 W JACKSON ST, MULBERRY, IN 46058-9538
- **Practice address phone:** (765) 296-2070
- **Practice address fax:** (765) 296-4380
- **Mailing address:** 3750 LANDMARK DRIVE, SUITE A, LAFAYETTE, IN 47905
- **Mailing address phone:** (765) 296-2070
- **Mailing address fax:** (765) 296-4390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | — |
| 207RH0003X | Hematology & Oncology Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 2084P2900X | Pain Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084P2900X | Pain Medicine (Psychiatry & Neurology) Physician | — | — | — |
| 2085N0904X | Nuclear Radiology Physician | — | NULL | — |
| 2085N0904X | Nuclear Radiology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 03/30/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 153848 | MEDICARE RURAL HEALTH | IN |
| 05 | — | 200256220A | — | IN |