# ST. VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER

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

## Provider details

- **NPI number:** 1740589860
- **Authorized official:** KYLE DEFUR (PRESIDENT)
- **Authorized official phone:** (317) 338-7031

## Contact information

- **Practice address:** 8227 NORTHWEST BLVD, SUITE 160, INDIANAPOLIS, IN 46278-1387
- **Practice address phone:** (317) 415-5795
- **Mailing address:** 10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 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