Organization
INDIANA UNIVERSITY HEALTH BALL MEMORIAL PHYSICIANS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI LUTHER (COO)
(317) 948-3525
Entity
Organization
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-3111
Mailing address
1200 W. WHITE RIVER BLVD., RCS PROVIDER ENROLLMENT, MUNCIE, IN 47303-4988
(765) 254-4009
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
208M00000X
Hospitalist Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200986050J
—
IN
01
—
DQ6230
RR MEDICARE
IN
Enumeration date
04/12/2010
Last updated
05/15/2019
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