Organization
CCCG, LLC
Active
Parent organization
CLARIAN HEALTH PARTNERS, INC
Other names
Methodist Cardiology Physicians
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLARIAN HEALTH PARTNERS, INC
Authorized official
SAMUEL L ODLE (PRESIDENT, CEO)
(317) 962-4836
Entity
Organization
Contact information
Practice address
1801 SENATE BLVD, METHODIST PROFESSIONAL CENTER, SUITE 310, INDIANAPOLIS, IN 46202-1228
(317) 962-4836
(317) 962-8646
Mailing address
250 N SHADELAND AVE, SUITE 200, INDIANAPOLIS, IN 46219-4959
(317) 962-4836
(317) 962-8646
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
Other
Enumeration date
07/11/2006
Last updated
09/21/2007
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