Organization
ST. VINCENT PHYSICIAN NETWORK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MCANDREWS (VICE PRESIDENT)
(317) 583-3194
Entity
Organization
Contact information
Practice address
11530 ALLISONVILLE RD, FISHERS, IN 46038-1866
(317) 415-5900
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
—
—
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200277740
—
IN
05
—
200817010
—
IN
05
—
200861610
—
IN
05
—
200922660
—
IN
Enumeration date
05/12/2006
Last updated
07/07/2011
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