Organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Active
Parent organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Authorized official
BEN H. PARK M.D. (PRESIDENT AND CEO)
(317) 580-6307
Entity
Organization
Contact information
Practice address
315 W OLD KEY DR, PERU, IN 46970-9057
(765) 475-6963
(765) 475-2833
Mailing address
315 W OLD KEY DR, PERU, IN 46970-9057
(765) 475-6963
(765) 475-2833
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2084N0400X
Neurology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0828280021
DMERC
IN
Enumeration date
06/29/2006
Last updated
01/09/2008
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