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SOUTHERN INDIANA PEDIATRICS LLC NPI 1417921933


NPI Information

NPI: 1417921933
Provider Name: SOUTHERN INDIANA PEDIATRICS, LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
350 S LANDMARK AVE
BLOOMINGTON, IN
ZIP 47403
Phone: (812) 335-2434
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SOUTHERN INDIANA PEDIATRICS, LLC is a pediatrics in Bloomington, IN. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SOUTHERN INDIANA PEDIATRICS, LLC NPI is 1417921933. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

350 S LANDMARK AVE
BLOOMINGTON, IN
ZIP 47403-001
Phone: (812) 335-2434
Fax: (812) 335-7604

The provider's authorized official is Michael Craig .
The authorized official title is Cfo and has the following contact phone number (812) 353-9554.

The enumeration date for this NPI number is 2/13/2006 and was last updated on 2/15/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200026580MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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