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Organization
ST. VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER
Active
Organization
ST. VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE DEFUR (PRESIDENT)
(317) 338-7031
Entity
Organization
Contact information
Practice address
8227 NORTHWEST BLVD, SUITE 160, INDIANAPOLIS, IN 46278-1387
(317) 415-5795
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
NULL
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
NULL
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
03/16/2011
Last updated
09/05/2013
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