Organization
HOOSIER EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TENNA K BEHM (OFFICER)
(469) 401-2386
Entity
Organization
Contact information
Practice address
2200 N SECTION ST, SULLIVAN, IN 47882-7523
(812) 268-4311
(812) 268-2650
Mailing address
PO BOX 13621, PHILADELPHIA, PA 19101-3621
(469) 401-2386
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000361474
BLUE SHIELD
IN
05
—
200524970A
—
IN
Enumeration date
06/02/2006
Last updated
01/22/2018
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