Organization
UROLOGY OF INDIANA L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY G. ORRIS M.D. (M.D. / OWNER)
(317) 859-7222
Entity
Organization
Contact information
Practice address
1 MEMORIAL SQ STE 225, GREENFIELD, IN 46140-1381
(317) 462-0700
(317) 462-6123
Mailing address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 859-7222
(317) 859-7220
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100194370Y
—
IN
01
—
1234980013
NSC PTAN
IN
01
—
1487680518
GROUP NPI
IN
Enumeration date
10/17/2006
Last updated
03/17/2021
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