Organization
PREMIER HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY W RATLIFF M.D. (PRESIDENT)
(812) 331-3400
Entity
Organization
Contact information
Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 355-6900
(812) 355-3251
Mailing address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 355-6900
(812) 355-3251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
208M00000X
Hospitalist Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200987480
—
IN
01
—
6440260001
MEDICARE DME
IN
Enumeration date
06/10/2010
Last updated
05/09/2013
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