# SOUTHSIDE OB/GYN P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTHSIDE OB/GYN P.C.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1285909002
- **Legal business name:** SOUTHSIDE OB/GYN P.C.
- **Authorized official:** MS. JOCELYN FOREHAND CMPE, CPC (CEO)
- **Authorized official phone:** (317) 865-3600

## Contact information

- **Practice address:** 1205 HADLEY RD, MOORESVILLE, IN 46158-1737
- **Practice address phone:** (317) 584-3454
- **Practice address fax:** (317) 584-3435
- **Mailing address:** 8051 S EMERSON AVE, 400, INDIANAPOLIS, IN 46237-8600
- **Mailing address phone:** (317) 865-3600
- **Mailing address fax:** (317) 885-3850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 02001767A | IN | Yes |

## Other

- **Enumeration date:** 03/12/2012
- **Last updated:** 12/14/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100047770 | — | IN |