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Organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Active
Organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Active
Parent organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Authorized official
BEN H PARK MD (PRESIDENT AND CEO)
(317) 580-6307
Entity
Organization
Contact information
Practice address
101 S. LIBERTY STREET, RUSSIAVILLE, IN 46979
(765) 883-2273
(765) 883-5168
Mailing address
PO BOX 400, RUSSIAVILLE, IN 46979-0400
(765) 883-2273
(765) 883-5168
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
NULL
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
NULL
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
09/07/2006
Last updated
01/09/2008
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