Organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Active
Parent organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Authorized official
BEN H PARK MD (PRESIDENT AND CEO)
(317) 580-6307
Entity
Organization
Contact information
Practice address
2343 W. LINCOLN ROAD, KOKOMO, IN 46902
(765) 455-4090
(765) 455-4091
Mailing address
2343 W. LINCOLN ROAD, KOKOMO, IN 46902
(765) 455-4090
(765) 455-4091
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH1052
RAILROAD MEDICARE
IN
Enumeration date
09/28/2006
Last updated
10/29/2007
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