Organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Active
Parent organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Authorized official
BEN H PARK MD (PRESIDENT AND CEO)
(317) 580-6307
Entity
Organization
Contact information
Practice address
1115 RONALD REAGAN PKWY, SUITE 224, AVON, IN 46123-6910
(317) 272-7352
(317) 272-0984
Mailing address
4850 CENTURY PLAZA RD, SUITE 180, INDIANAPOLIS, IN 46254-5476
(317) 272-7352
(317) 272-0984
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH1019
RAILROAD MEDICARE
IN
Enumeration date
09/15/2006
Last updated
10/30/2007
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