Organization
ASSOCIATED PHYSICIANS & SURGEONS CLINIC, LLC
Active
Parent organization
ASSOCIATED PHYSICIAN & SURGEONS CLINIC, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASSOCIATED PHYSICIAN & SURGEONS CLINIC, LLC
Authorized official
MICHAEL P FOUTY (CFO/AUTHORIZED REPRESENTATIVE)
(812) 232-0564
Entity
Organization
Contact information
Practice address
1739 N 4TH ST, TERRE HAUTE, IN 47804-4002
(812) 232-0564
(812) 242-3848
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 232-0564
(812) 242-3848
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176835
US DEPT OF LABOR
—
01
—
ZD3948
OPTIMUM CHOICE INC
—
Enumeration date
10/24/2006
Last updated
04/20/2008
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