Organization
HOSPITALISTS OF WABASH VALLEY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM TEDRICK JOHNSON (VICE PRESIDENT)
(703) 650-2907
Entity
Organization
Contact information
Practice address
3901 S 7TH ST, TERRE HAUTE, IN 47802-5709
(812) 237-1100
Mailing address
3901 S 7TH ST, TERRE HAUTE, IN 47802-5709
(812) 237-1100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200922950A
—
IN
Enumeration date
11/12/2007
Last updated
01/18/2011
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