Organization
ST. VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE DEFUR (PRESIDENT)
(317) 338-7031
Entity
Organization
Contact information
Practice address
8227 NORTHWEST BLVD, SUITE 160, INDIANAPOLIS, IN 46278-1387
(317) 415-5795
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
03/16/2011
Last updated
09/05/2013
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