Organization
EASTERN INDIANA CENTER FOR AMBULATORY SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH M SMITH M.D. (MEDICAL DIRECTOR)
(765) 939-1351
Entity
Organization
Contact information
Practice address
1350 CHESTER BLVD, RICHMOND, IN 47374-1907
(765) 939-1351
Mailing address
1350 CHESTER BLVD, RICHMOND, IN 47374-1907
(765) 939-1351
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000098211
ANTHEM PROVIDER NUMBER
IN
05
—
2069532
—
OH
Enumeration date
02/21/2006
Last updated
08/22/2020
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