Organization
NORTHEAST OTOLARYNGOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODINE DIANE STAEBLER CPA (PRACTICE ADMINISTRATOR)
(317) 621-6673
Entity
Organization
Contact information
Practice address
18000 RIVER AVE, NOBLESVILLE, IN 46062-8329
(317) 621-6673
(317) 621-3073
Mailing address
18000 RIVER AVE, NOBLESVILLE, IN 46062-8329
(317) 621-6673
(317) 621-3073
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YX0602X
Otolaryngic Allergy Physician
—
—
Other
Enumeration date
05/26/2006
Last updated
03/10/2015
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