Organization
MONTICELLO EMERGENCY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIKA O'BRIEN M.D. (CEO)
(765) 446-0170
Entity
Organization
Contact information
Practice address
4011 S MONROE MEDICAL PARK BLVD, BLOOMINGTON, IN 47403-8000
(812) 825-1111
Mailing address
3500 STATE ROAD 38 E STE 300, LAFAYETTE, IN 47905-5167
(765) 446-0170
(855) 506-7359
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300065600
—
IN
01
—
DD5512
RAIL ROAD MEDICARE
IN
Enumeration date
07/09/2006
Last updated
02/07/2023
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