Organization
CENTRAL INDIANA ORTHOPEDICS, LLC
Active
Organization
CENTRAL INDIANA ORTHOPEDICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR P MORAN (EXEXUTIVE DIRECTOR/CFO)
(765) 284-7738
Entity
Organization
Contact information
Practice address
2610 ENTERPRISE DR, ANDERSON, IN 46013-9684
(765) 683-4400
(765) 213-3713
Mailing address
PO BOX 1643, MUNCIE, IN 47308-1643
(765) 284-7738
(765) 213-3713
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000102884
ANTHEM PIN
IN
05
—
100106820
—
IN
Enumeration date
08/20/2006
Last updated
02/06/2023
Update your record
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