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Organization

ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.

Active
Other names
ST. VINCENT PHYSICIAN SERVICES (NEUROPSYCH)
Organization subpart
No

Provider details

NPI number
Authorized official
D. BRUCE HAGA (VICE PRESIDENT)
(317) 583-3087
Entity
Organization

Contact information

Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-3103
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
103TC0700X
Clinical Psychologist
103TC2200X
Clinical Child & Adolescent Psychologist
103TE1100X
Exercise & Sports Psychologist
207V00000X
Obstetrics & Gynecology Physician
207VX0201X
Gynecologic Oncology Physician

Other

Enumeration date
11/01/2007
Last updated
11/01/2007
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