Organization
SOUTHEASTERN INDIANA GASTROENTEROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE COLE BILLING OFFICE (PATIENT ACCOUNT REPRESENTATIVE)
(812) 372-8680
Entity
Organization
Contact information
Practice address
2630 22ND ST, COLUMBUS, IN 47201-3702
(812) 372-8680
(812) 372-9265
Mailing address
2630 22ND ST, COLUMBUS, IN 47201-3702
(812) 372-8680
(812) 372-9265
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01033813A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000317541
ICHIA PROVIDER NUMBER
IN
01
—
050176P
SIHO PROVIDER NUMBER
IN
Enumeration date
11/08/2005
Last updated
08/22/2020
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