CLEANSLATE MEDICAL GROUP OF INDIANA LLC NPI 1023464294

NPI Information

CLEANSLATE MEDICAL GROUP OF INDIANA LLC is an addiction medicine internal medicine in Evansville, IN. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. CLEANSLATE MEDICAL GROUP OF INDIANA LLC NPI is 1023464294. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4411 WASHINGTON AVE STE 105
EVANSVILLE, IN
ZIP 47714-805
Phone: (812) 213-0304

The provider's authorized official is Robert Hutchison .
The authorized official title is Cfo and has the following contact phone number (615) 425-0220.

The enumeration date for this NPI number is 5/6/2016 and was last updated on 3/23/2023.

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:

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