# INDIANA UNIVERSITY HEALTH PROTON THERAPY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Midwest Proton Radiotherapy Institute, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780775163
- **Authorized official:** MR. JOHN KERSTIENS CPA (COO/CFO)
- **Authorized official phone:** (812) 349-5028

## Contact information

- **Practice address:** 2425 MILO B. SAMPSON LANE, BLOOMINGTON, IN 47408-1398
- **Practice address phone:** (812) 349-5074
- **Practice address fax:** (812) 349-5046
- **Mailing address:** 2425 MILO B. SAMPSON LANE, BLOOMINGTON, IN 47408-1398
- **Mailing address phone:** (812) 349-5074
- **Mailing address fax:** (812) 349-5046

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0203X | Radiation Oncology Clinic/Center | NA | NULL | Yes |

## Other

- **Enumeration date:** 09/28/2006
- **Last updated:** 11/28/2012