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Organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Active
Organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Active
Parent organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Authorized official
BEN H PARK M.D. (PRESIDENT AND CEO)
(317) 580-6307
Entity
Organization
Contact information
Practice address
3750 LANDMARK DRIVE, SUITE A, LAFAYETTE, IN 47905
(765) 448-4511
(765) 447-8375
Mailing address
3750 LANDMARK DRIVE, SUITE A, LAFAYETTE, IN 47905
(765) 448-4511
(765) 447-8375
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
NULL
2085U0001X
Diagnostic Ultrasound Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0828280023
DMERC
IN
01
—
153833
MEDICARE RURAL HEALTH
IN
05
—
200127640A
—
IN
Enumeration date
06/25/2006
Last updated
01/22/2009
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