Organization
VINCENNES NEUROSURGICAL CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN PAUL GROSSMITH MD (OWNER PROVIDER)
(812) 830-8788
Entity
Organization
Contact information
Practice address
700 WILLOW ST STE 203, VINCENNES, IN 47591-1028
(812) 886-3850
(812) 885-3737
Mailing address
700 WILLOW ST STE 203, VINCENNES, IN 47591-1028
(812) 886-3850
(812) 885-3737
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01062317A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000486234
BLUE CROSS BLUE SHIELD
IN
Enumeration date
07/22/2006
Last updated
11/30/2007
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