Organization
SURGICAL ASSOCIATES SOUTHERN INDIANA, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL C MACMILLAN M.D. (PRESIDENT/DIRECTOR)
(812) 282-0637
Entity
Organization
Contact information
Practice address
301 GORDON GUTMANN BLVD, SUITE 401, JEFFERSONVILLE, IN 47130-3764
(812) 282-0637
(812) 283-6330
Mailing address
301 GORDON GUTMANN BLVD, SUITE 401, JEFFERSONVILLE, IN 47130-3739
(812) 282-0637
(812) 283-6330
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
50003241A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200105360A
—
IN
01
—
50003241A
MED. CORP. CERTIFICATION
IN
Enumeration date
09/13/2005
Last updated
03/30/2010
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