Organization
ALLERGY & ASTHMA OF SOUTHERN INDIANA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL R MCCORMACK D.O. (PRESIDENT)
(812) 334-1198
Entity
Organization
Contact information
Practice address
485 S LANDMARK AVE, BLOOMINGTON, IN 47403-5005
(812) 334-1198
(812) 334-1199
Mailing address
485 S LANDMARK AVE, BLOOMINGTON, IN 47403-5005
(812) 334-1198
(812) 334-1199
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
50003795A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200094140
—
IN
Enumeration date
10/04/2006
Last updated
08/08/2011
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