Organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Active
Parent organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Authorized official
BEN H PARK MD (PRESIDENT AND CEO)
(317) 580-6307
Entity
Organization
Contact information
Practice address
276 MANCHESTER AVE, WABASH, IN 46992-1808
(260) 563-2126
(260) 563-2120
Mailing address
315 W OLD KEY DR, PERU, IN 46970-9057
(260) 563-2126
(260) 563-2120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
208600000X
Surgery Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100127480E
—
IN
Enumeration date
08/31/2006
Last updated
06/22/2017
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