| Premise Health Of Indiana Medical, P.c. | |
|
2815 Indianapolis Blvd # Mc113 Whiting IN 46394-2197 | |
| (219) 473-3072 | |
| (219) 473-5488 |
| Full Name | Premise Health Of Indiana Medical, P.c. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2815 Indianapolis Blvd # Mc113, Whiting, Indiana |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Indiana Medical, P.c. 5500 Maryland Way Brentwood TN 37027-7048 Ph: () - | Premise Health Of Indiana Medical, P.c. 2815 Indianapolis Blvd # Mc113 Whiting IN 46394-2197 Ph: (219) 473-3072 |
| NPI Number | 1699446948 |
|---|---|
| Provider Enumeration Date | 09/27/2021 |
| Last Update Date | 08/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699446948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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