Organization
GENERAL OTORHINOLARYNGOLOGICAL FOUNDATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD T. MIYAMOTO M.D. (PRESIDENT)
(317) 630-8970
Entity
Organization
Contact information
Practice address
705 RILEY HOSPITAL DR, 0860, INDIANAPOLIS, IN 46202-5128
(317) 630-8970
(317) 630-8958
Mailing address
705 RILEY HOSPITAL DR, 0860, INDIANAPOLIS, IN 46202-5128
(317) 630-8970
(317) 630-8958
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100048070
—
IN
Enumeration date
08/08/2006
Last updated
02/17/2011
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