Organization
CENTRAL INDIANA ORTHOPEDICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR P MORAN (EXECUTIVE DIRECTOR/CFO)
(765) 284-7738
Entity
Organization
Contact information
Practice address
500 W VOTAW ST, PORTLAND, IN 47371-1322
(260) 726-7131
Mailing address
PO BOX 1643, MUNCIE, IN 47308-1643
(765) 284-7738
(765) 213-3713
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000102884
ANTHEM
IN
05
—
100106820
—
IN
Enumeration date
10/31/2014
Last updated
11/29/2022
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