Organization
SOUTHERN INDIANA PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CRAIG (CFO)
(812) 353-9554
Entity
Organization
Contact information
Practice address
350 S LANDMARK AVE, BLOOMINGTON, IN 47403-5001
(812) 335-2434
(812) 335-7604
Mailing address
350 S LANDMARK AVE, BLOOMINGTON, IN 47403-5001
(812) 335-2434
(812) 335-7604
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200026580
—
IN
Enumeration date
02/13/2006
Last updated
02/15/2018
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