Organization
PHYSICIAN PROVIDER SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE CREESE (CEO)
(317) 672-8600
Entity
Organization
Contact information
Practice address
11690 GROOMS RD, BLUE ASH, OH 45242-1412
(800) 526-6797
Mailing address
1 INDIANA SQ STE 2060, INDIANAPOLIS, IN 46204-2020
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/15/2024
Last updated
06/06/2024
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