Organization
SANDERS MEDICAL, LLC
Active
Other names
TriState Integrative Pain Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANT STEVEN SANDERS MD (PRESIDENT)
(812) 449-2733
Entity
Organization
Contact information
Practice address
2516 WASHINGTON AVE, EVANSVILLE, IN 47714-2404
(812) 449-2733
Mailing address
PO BOX 5328, EVANSVILLE, IN 47716-5328
(812) 449-2733
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01048158A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200236040
—
IN
05
—
201069840
—
IN
Enumeration date
04/24/2012
Last updated
10/11/2012
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