# FAMILY MEDICINE OF TERRE HAUTE, LLC

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

## Provider details

- **NPI number:** 1801065552
- **Authorized official:** BRIDGETT SULLIVAN (OFFICE MANAGER)
- **Authorized official phone:** (812) 237-9890

## Contact information

- **Practice address:** 3903 S 7TH ST, SUITE 2F, TERRE HAUTE, IN 47802-5710
- **Practice address phone:** (812) 237-9890
- **Mailing address:** 3903 S 7TH ST, SUITE 2F, TERRE HAUTE, IN 47802-5710
- **Mailing address phone:** (812) 237-9890

## Taxonomy

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

## Other

- **Enumeration date:** 02/27/2008
- **Last updated:** 01/07/2009