| Indiana University Health Southern Indiana Physicians Llc | |
|
7 E Main St Gosport IN 47433-7034 | |
| (812) 879-4222 | |
| (812) 879-4834 |
| Full Name | Indiana University Health Southern Indiana Physicians Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 7 E Main St, Gosport, Indiana |
| Authorized Official Name and Position | Marlon B Fishel (ADMINISTRATION, IU HEALTH SIP) |
| Authorized Official Contact | 8123535866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indiana University Health Southern Indiana Physicians Llc Po Box 1329 Bloomington IN 47402-1329 Ph: (812) 879-4222 | Indiana University Health Southern Indiana Physicians Llc 7 E Main St Gosport IN 47433-7034 Ph: (812) 879-4222 |
| NPI Number | 1003074972 |
|---|---|
| Provider Enumeration Date | 05/28/2008 |
| Last Update Date | 07/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003074972 | NPI | - | NPPES |
| 200874400A | Medicaid | IN | |
| CI4187 | Other | IN | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Indiana) | Primary |