Organization
UROLOGY OF INDIANA L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY G. ORRIS M.D. (M.D./OWNER)
(317) 859-7222
Entity
Organization
Contact information
Practice address
2451 INTELLIPLEX DR, SUITE 250, SHELBYVILLE, IN 46176-8580
(317) 398-5303
(317) 398-1817
Mailing address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 859-7222
(317) 859-7220
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100194370 Q
—
IN
01
—
1487680518
GROUP NPI
IN
Enumeration date
12/10/2014
Last updated
03/17/2021
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