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Organization
GULFPORT TESTING
Active
Organization
GULFPORT TESTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE K FITZHARRIS M.D. (PRESIDENT/CEO)
(818) 235-9054
Entity
Organization
Contact information
Practice address
2425 N MERIDIAN ST, INDIANAPOLIS, IN 46208-5820
(818) 235-9054
Mailing address
2425 N MERIDIAN ST, INDIANAPOLIS, IN 46208-5820
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01037152A
IN
Other
Enumeration date
01/29/2009
Last updated
01/29/2009
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