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Organization
NORTHSIDE OB/GYN INC
Active
Organization
NORTHSIDE OB/GYN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES AUSTIN MYERS MD (PHYSICIAN SECRETARY & TREASURER)
(317) 872-8660
Entity
Organization
Contact information
Practice address
8330 NAAB RD, SUITE # 103, INDPLS, IN 46260
(317) 872-8660
(317) 872-6524
Mailing address
8330 NAAB RD, SUITE # 103, INDPLS, IN 46260
(317) 872-8660
(317) 872-6524
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01022825
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083369
ANTHEM
—
05
—
10036223OA
—
IN
Enumeration date
10/23/2006
Last updated
08/22/2020
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