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7250 Clearvista Dr Ste 225 Indianapolis IN 46256-5626 | |
| (317) 537-6088 | |
| (317) 537-6092 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 7250 Clearvista Dr Ste 225, Indianapolis, Indiana |
| Authorized Official Name and Position | William D Earwood (CFO/CIO) |
| Authorized Official Contact | 3173082828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6983 Hillsdale Ct Indianapolis IN 46250-2054 Ph: (317) 849-8350 | 7250 Clearvista Dr Ste 225 Indianapolis IN 46256-5626 Ph: (317) 537-6088 |
| NPI Number | 1871680033 |
|---|---|
| Provider Enumeration Date | 10/09/2006 |
| Last Update Date | 12/05/2023 |
| Certification Date | 12/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871680033 | NPI | - | NPPES |
| 100218760B | Medicaid | IN | |
| CJ9849 | Other | MEDICARE RR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (Indiana) | Primary |
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