Individual
DR. PHILIP H IRELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13100 E 136TH ST, STE 200, FISHERS, IN 46037-9478
(317) 688-5980
(317) 678-3222
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01025374A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100061600
—
IN
Enumeration date
05/24/2005
Last updated
02/06/2014
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