Organization
ASSOCIATED PHYSICIANS & SURGEONS CLINIC, LLC
Active
Parent organization
ASSOCIATED PHYSICIANS & SURGEONS CLINIC, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASSOCIATED PHYSICIANS & SURGEONS CLINIC, LLC
Authorized official
MICHAEL P FOUTY (CFO/AUTHORIZED REPRESENTATIVE)
(812) 232-0564
Entity
Organization
Contact information
Practice address
422 POPLAR ST, TERRE HAUTE, IN 47807-4209
(812) 232-0564
(812) 242-3848
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 232-0564
(812) 242-3848
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207N00000X
Dermatology Physician
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176835
US DEPT OF LABOR
—
01
—
ZD3948
OPTIMUM CHOICE INC
—
Enumeration date
10/24/2006
Last updated
04/20/2008
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