# UNION ASSOCIATED PHYSICIANS CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Indiana State University
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326588997
- **Authorized official:** MICHAEL MARIETTA (REVENUE CYCLE DIRECTOR)
- **Authorized official phone:** (812) 232-0564

## Contact information

- **Practice address:** 567 N 5TH ST, TERRE HAUTE, IN 47809-1903
- **Practice address phone:** (812) 237-3883
- **Practice address fax:** (812) 237-7955
- **Mailing address:** 221 S 6TH ST, TERRE HAUTE, IN 47807-4214
- **Mailing address phone:** (812) 232-0564
- **Mailing address fax:** (812) 242-3861

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/02/2017
- **Last updated:** 03/02/2017