Individual
S. AURORA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1473 E STATE ROAD 44, SUITE 4, CONNERSVILLE, IN 47331-8374
(765) 827-6612
(765) 827-6910
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 827-6612
(765) 827-6910
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01041571
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000705719
ANTHEM
—
05
—
100388460
—
IN
Enumeration date
11/28/2005
Last updated
05/13/2021
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