Richard J Eisenhut, MD | |
482 S Liberty Dr, Bloomington, IN 47403-1927 | |
(812) 353-3443 | |
Not Available |
Full Name | Richard J Eisenhut |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 482 S Liberty Dr, Bloomington, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023036167 | NPI | - | NPPES |
01032777A | Other | IN | INDIANA LICENSE |
01032777B | Other | IN | CSR |
100331200 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 01032777A (Indiana) | Primary |
207P00000X | Emergency Medicine | 01032777A (Indiana) | Secondary |
Entity Name | Indiana University Health Southern Indiana Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013953983 PECOS PAC ID: 6204748197 Enrollment ID: O20040423000556 |
Mailing Address | Practice Location Address |
---|---|
Richard J Eisenhut, MD 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Richard J Eisenhut, MD 482 S Liberty Dr, Bloomington, IN 47403-1927 Ph: (812) 353-3443 |
Wai Pok Vernon Chan, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408 Phone: 812-676-4102 Fax: 812-676-4106 | |
Dr. Kevin Edward Zawacki, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1312 W. Arch Haven Avenue, Bloomington, IN 47403 Phone: 812-676-4144 Fax: 812-339-8344 | |
Dr. Samuel W Kimani, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 550 S Landmark Ave, Bloomington, IN 47403 Phone: 812-331-3400 Fax: 812-332-7265 | |
Shelby Renee Tipton, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408 Phone: 812-676-4106 Fax: 812-676-4102 | |
Ms. Louise Anne Owens, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 500 S Madison St, Bloomington, IN 47403 Phone: 812-334-3303 Fax: 812-334-0842 | |
Mohan Shenoy, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1312 W. Arch Haven Avenue, Bloomington, IN 47403 Phone: 812-676-4144 Fax: 812-339-8344 |