Organization
SOUTHSIDE FAMILY PHYSICIANS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBIN ANN MALUCK (OFFICE MANAGER)
(317) 888-2811
Entity
Organization
Contact information
Practice address
8523 MADISON AVE, SUITE A, INDIANAPOLIS, IN 46227-6115
(317) 888-2811
(317) 888-2822
Mailing address
8523 MADISON AVE, SUITE A, INDIANAPOLIS, IN 46227-6115
(317) 888-2811
(317) 888-2822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100057680A
—
IN
Enumeration date
12/19/2006
Last updated
06/02/2014
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