Organization
GEORGE R SMALL JR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE R SMALL, JR MD (MD)
(317) 422-5490
Entity
Organization
Contact information
Practice address
284 N MADISON AVE, GREENWOOD, IN 46142-3634
(317) 888-7745
Mailing address
284 N MADISON AVE, GREENWOOD, IN 46142-3634
(317) 888-7745
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
01022870A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100151110A
—
IN
01
—
11068524
MEDICARE RAILROAD
IN
01
—
17300000X
TAXONOMY
IN
01
—
87581
ANTHEM BLUE CROSS
IN
Enumeration date
07/21/2008
Last updated
07/21/2008
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