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Organization
CENTER FOR ORTHOPAEDIC SURGERY AND SPORTS MEDICINE
Active
Organization
CENTER FOR ORTHOPAEDIC SURGERY AND SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETHANY A VAUGHN PA (PA)
(317) 888-1051
Entity
Organization
Contact information
Practice address
8141 S EMERSON AVE, SUITE A, INDIANAPOLIS, IN 46237-8560
(317) 888-1051
(317) 888-1591
Mailing address
8141 S EMERSON AVE, SUITE A, INDIANAPOLIS, IN 46237-8560
(317) 888-1051
(317) 888-1591
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
99063581A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99063581A
LICENSE
IN
Enumeration date
09/17/2014
Last updated
11/17/2014
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