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Organization
SOUTHSIDE OB/GYN P.C.
Active
Organization
SOUTHSIDE OB/GYN P.C.
Active
Parent organization
SOUTHSIDE OB/GYN P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHSIDE OB/GYN P.C.
Authorized official
MS. JOCELYN FOREHAND CMPE, CPC (CEO)
(317) 865-3600
Entity
Organization
Contact information
Practice address
1205 HADLEY RD, MOORESVILLE, IN 46158-1737
(317) 584-3454
(317) 584-3435
Mailing address
8051 S EMERSON AVE, 400, INDIANAPOLIS, IN 46237-8600
(317) 865-3600
(317) 885-3850
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
02001767A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100047770
—
IN
Enumeration date
03/12/2012
Last updated
12/14/2017
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