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Organization
GRAND OLE DOCS OF THE SOUTHSIDE, LLC
Active
Organization
GRAND OLE DOCS OF THE SOUTHSIDE, LLC
Active
Other names
Central Indiana Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY N DEWESTER MD (OWNER)
(317) 807-0247
Entity
Organization
Contact information
Practice address
6349 S EAST ST, INDIANAPOLIS, IN 46227-7107
(317) 807-0247
(317) 735-1951
Mailing address
1350 E COUNTY LINE RD, SUITE H, INDIANAPOLIS, IN 46227-0873
(317) 887-7725
(317) 887-7751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01036126A
IN
Other
Enumeration date
11/14/2007
Last updated
12/05/2013
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