GRAND OLD DOCS OF THE SOUTHSIDE NPI 1720277544

NPI Information

GRAND OLD DOCS OF THE SOUTHSIDE is a family medicine in Indianapolis, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GRAND OLD DOCS OF THE SOUTHSIDE NPI is 1720277544. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Central Indiana Medical Group.

The provider's business location address is:

8920 SOUTHPOINTE DR
SUITE E-1
INDIANAPOLIS, IN
ZIP 46227-509
Phone: (317) 882-0535
Fax: (317) 882-0173

The provider's authorized official is Robert E Dicks .
The authorized official title is Md/owner and has the following contact phone number (317) 882-0535.

The enumeration date for this NPI number is 10/17/2007 and was last updated on 6/27/2008.

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:

Other Identifiers

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

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