Organization
INDIANAPOLIS NEUROSURGICAL GROUP
Active
Organization
INDIANAPOLIS NEUROSURGICAL GROUP
Active
Other names
Goodman Campbell Brain and Spine
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK CANTRELL (EXEC DIRECTOR FINANCE)
(317) 396-1300
Entity
Organization
Contact information
Practice address
1925 N. CAPITOL AVENUE, INDIANAPOLIS, IN 46202
(317) 396-1300
Mailing address
8333 NAAB RD, 255, INDIANAPOLIS, IN 46260-5924
(317) 396-1300
Taxonomy
Speciality
Code
Description
License number
State
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100318390R
—
IN
Enumeration date
04/26/2007
Last updated
12/29/2009
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