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Individual

JOHN C SORG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 676-4102
Mailing address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 676-4715

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01036183A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100113970A
IN
05
204482806
MO
Enumeration date
06/15/2005
Last updated
09/26/2024
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