| 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 | |
Eric A Bannec, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 550 S Landmark Ave, Bloomington, IN 47403 Phone: 812-355-3255 Fax: 812-333-5978 |