# CENTER FOR ORTHOPAEDIC SURGERY AND SPORTS MEDICINE

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

## Provider details

- **NPI number:** 1942602362
- **Authorized official:** MS. BETHANY A VAUGHN PA (PA)
- **Authorized official phone:** (317) 888-1051

## Contact information

- **Practice address:** 8141 S EMERSON AVE, SUITE A, INDIANAPOLIS, IN 46237-8560
- **Practice address phone:** (317) 888-1051
- **Practice address fax:** (317) 888-1591
- **Mailing address:** 8141 S EMERSON AVE, SUITE A, INDIANAPOLIS, IN 46237-8560
- **Mailing address phone:** (317) 888-1051
- **Mailing address fax:** (317) 888-1591

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 99063581A | IN | Yes |

## Other

- **Enumeration date:** 09/17/2014
- **Last updated:** 11/17/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 99063581A | LICENSE | IN |