# NORTHSIDE OB/GYN INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649353657
- **Authorized official:** MR. JAMES AUSTIN MYERS MD (PHYSICIAN SECRETARY & TREASURER)
- **Authorized official phone:** (317) 872-8660

## Contact information

- **Practice address:** 8330 NAAB RD, SUITE \# 103, INDPLS, IN 46260
- **Practice address phone:** (317) 872-8660
- **Practice address fax:** (317) 872-6524
- **Mailing address:** 8330 NAAB RD, SUITE \# 103, INDPLS, IN 46260
- **Mailing address phone:** (317) 872-8660
- **Mailing address fax:** (317) 872-6524

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 01022825 | IN | Yes |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000083369 | ANTHEM | — |
| 05 | — | 10036223OA | — | IN |