# SURGICAL SERVICES OF NORTHERN INDIANA, LLC

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

## Provider details

- **NPI number:** 1699729111
- **Authorized official:** MR. TIMOTHY BARNARD PA-C (PRESIDENT)
- **Authorized official phone:** (574) 261-9444

## Contact information

- **Practice address:** 50744 PHEASANT COVE DR, GRANGER, IN 46530-8835
- **Practice address phone:** (574) 261-9444
- **Practice address fax:** (574) 272-2220
- **Mailing address:** 50744 PHEASANT COVE DR, GRANGER, IN 46530-8835
- **Mailing address phone:** (574) 273-1232
- **Mailing address fax:** (574) 272-2220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | 1000226A | IN | Yes |

## Other

- **Enumeration date:** 05/20/2006
- **Last updated:** 08/22/2020