Organization
UROLOGY OF INDIANA, LLC
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
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 859-7222
(317) 859-7220
Mailing address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 885-1250
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487680518
GROUP NPI
IN
Enumeration date
10/11/2016
Last updated
03/17/2021
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