Organization
INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS, LLC
Active
Parent organization
INDIANA UNIVERSITY HEALTH BLOOMINGTON INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDIANA UNIVERSITY HEALTH BLOOMINGTON INC
Authorized official
MR. MICHAEL CRAIG (CFO)
(812) 353-9171
Entity
Organization
Contact information
Practice address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 353-5252
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(888) 484-3258
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
213E00000X
Podiatrist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100433840
—
IN
01
—
CI4187
RAILROAD MEDICARE ID
—
Enumeration date
06/21/2006
Last updated
02/29/2024
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