# AMERICAN HEALTH NETWORK OF INDIANA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AMERICAN HEALTH NETWORK OF INDIANA, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780610089
- **Legal business name:** AMERICAN HEALTH NETWORK OF INDIANA, LLC
- **Authorized official:** BEN H PARK M.D. (PRESIDENT AND CEO)
- **Authorized official phone:** (317) 580-6307

## Contact information

- **Practice address:** 3750 LANDMARK DRIVE, SUITE A, LAFAYETTE, IN 47905
- **Practice address phone:** (765) 448-4511
- **Practice address fax:** (765) 447-8375
- **Mailing address:** 3750 LANDMARK DRIVE, SUITE A, LAFAYETTE, IN 47905
- **Mailing address phone:** (765) 448-4511
- **Mailing address fax:** (765) 447-8375

## Taxonomy

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

- **Enumeration date:** 06/25/2006
- **Last updated:** 01/22/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0828280023 | DMERC | IN |
| 01 | — | 153833 | MEDICARE RURAL HEALTH | IN |
| 05 | — | 200127640A | — | IN |