Organization
UTLEY CLINICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA LYNN UTLEY-BRENEMAN D.P.M. (PRESIDENT)
(765) 296-9842
Entity
Organization
Contact information
Practice address
720 S 6TH ST, MONTICELLO, IN 47960-8182
(765) 296-9842
(765) 296-9842
Mailing address
761 N 900 E, LAFAYETTE, IN 47905-7569
(765) 296-9842
(765) 296-9842
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000682A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000016511
SENIOR SMART CHOICE
IN
01
—
000000196527
BLUE CROSS BLUE SHIELD
IN
01
—
000185153
APWU
MD
01
—
00019652701
IN COMP HEALTH
IN
01
—
0004625100
AETNA
TX
05
—
100129410A
—
IN
01
—
1275
ARNETT
IN
01
—
407560
MEDICARE PTAN
IN
01
—
480007608
PALMETTO GBA - RAILROAD M
GA
01
—
691083
BANKERS LIFE AND CASUALTY
WA
Enumeration date
02/07/2007
Last updated
06/21/2018
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