Organization
NORTHCENTRAL INDANA ORTHOPEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN T SHOCKNEY (PRESIDENT & CEO)
(574) 753-1385
Entity
Organization
Contact information
Practice address
1601 CHASE RD, LOGANSPORT, IN 46947-1538
(574) 753-4193
Mailing address
1601 CHASE RD, LOGANSPORT, IN 46947-1538
(574) 753-4193
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
50001893A
IN
Other
Enumeration date
07/24/2006
Last updated
08/22/2020
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