| Physician Provider Services Llc | |
|
900 N High School Rd Indianapolis IN 46214-3759 | |
| (800) 526-6797 | |
| Not Available |
| Full Name | Physician Provider Services Llc |
|---|---|
| Speciality | Hospitalist |
| Location | 900 N High School Rd, Indianapolis, Indiana |
| Authorized Official Name and Position | Andre Creese (CEO) |
| Authorized Official Contact | 3176728600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Provider Services Llc 1 Indiana Sq Ste 2060 Indianapolis IN 46204-2020 Ph: () - | Physician Provider Services Llc 900 N High School Rd Indianapolis IN 46214-3759 Ph: (800) 526-6797 |
| NPI Number | 1982463600 |
|---|---|
| Provider Enumeration Date | 03/15/2024 |
| Last Update Date | 05/28/2024 |
| Medicare PECOS PAC ID | 1052753753 |
|---|---|
| Medicare Enrollment ID | O20240528000541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982463600 | NPI | - | NPPES |
| Provider Name | Amber N Gullion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013230911 PECOS PAC ID: 4880727353 Enrollment ID: I20100804000556 |
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