Organization
NEUROSURGICAL CLINIC OF BLOOMINGTON INC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHALL M. POOR M.D. (PRESIDENT)
(812) 331-8168
Entity
Organization
Contact information
Practice address
700 S COLLEGE AVE, SUITE A, BLOOMINGTON, IN 47403-2500
(812) 331-8168
(812) 331-1096
Mailing address
700 S COLLEGE AVE, SUITE A, BLOOMINGTON, IN 47403-2500
(812) 331-8168
(812) 331-1096
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01039391
IN
174400000X
Specialist
Primary
01040149
IN
174400000X
Specialist
01051484
IN
Other
Enumeration date
09/20/2005
Last updated
03/05/2024
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