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Organization
SAINT JOHN HEALTH SYSTEM
Active
Organization
SAINT JOHN HEALTH SYSTEM
Active
Other names
Anderson Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
D BRUCE HAGA (VICE PRESIDENT)
(317) 583-3087
Entity
Organization
Contact information
Practice address
141 W 22ND ST, ANDERSON, IN 46016-4304
(765) 641-7100
(765) 641-7115
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
06/29/2006
Last updated
12/03/2007
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