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Organization

INDIANAPOLIS NEUROSURGICAL GROUP

Active
Other names
Goodman Campbell Brain and Spine
Organization subpart
No

Provider details

NPI number
Authorized official
DEREK CANTRELL (CFO)
(317) 396-1386
Entity
Organization

Contact information

Practice address
2525 W UNIVERSITY AVE, SUITE 503, MUNCIE, IN 47303-3421
(765) 288-0441
(765) 282-7879
Mailing address
8333 NAAB RD, SUITE 250, INDIANAPOLIS, IN 46260-5924
(317) 396-1300
(317) 396-1346

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200235010A
IN
05
200971560N
IN
Enumeration date
11/28/2006
Last updated
04/17/2014
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