Organization
COMMUNITY HOSPITALS OF INDIANA INC
Active
Other names
Northside Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY KIRKHAM (CFO)
(317) 355-5822
Entity
Organization
Contact information
Practice address
8202 CLEARVISTA PKWY, SUITE 6B, INDIANAPOLIS, IN 46256-1442
(317) 579-1670
(317) 579-1680
Mailing address
8202 CLEARVISTA PKWY, SUITE 6B, INDIANAPOLIS, IN 46256-1442
(317) 579-1670
(317) 579-1680
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200406960 P
—
IN
05
—
200406960A
—
IN
01
—
DD2062
MEDICARE RAILROAD
IN
Enumeration date
07/16/2006
Last updated
12/17/2010
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