Grand Ole Docs Of The Southside, Llc in Indianapolis - Family Medicine
Grand Ole Docs Of The Southside, Llc - NPI 1871693994
Grand Ole Docs Of The Southside, Llc is a Family Medicine in Indianapolis, Indiana. Grand Ole Docs Of The Southside, Llc practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Grand Ole Docs Of The Southside, Llc is 1871693994. The last update date is 2013-12-05.
Grand Ole Docs Of The Southside, Llc's current location address is 1350 E County Line Rd, Indianapolis, Indiana. You can contact this provider via phone number 3178877725 and fax number 3178877751. The mailing address for Grand Ole Docs Of The Southside, Llc is 1350 E County Line Rd, Indianapolis, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Grand Ole Docs Of The Southside, Llc |
|---|---|
| Address | 1350 E County Line Rd, Indianapolis, Indiana |
| Phone Number | 3178877725 |
| Fax Number | 3178877751 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MANAGING P |
|---|---|
| Authorized Official Name | Klaasen V Robert |
| Credentials | MD |
| Telephone Number | 3178826663 |
NPI Number Detail
| NPI Number | 1871693994 |
|---|---|
| Provider Enumeration Date | 2006-09-25 |
| Last Updated Date | 2013-12-05 |
Provider Mailing Address Detail
| Address | 1350 E County Line Rd |
|---|---|
| City | Indianapolis |
| State | Indiana (IN) |
| Post Code | 462270873 |
| Phone Number | 3178877725 |
| Fax Number | 3178877751 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
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Definition: 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 i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| CI4722 | IN | GROUP RR MEDICARE # | |
| 5457630001 | IN | DME |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Grand Ole Docs Of The Southside, Llc by the Centers for Medicare & Medicaid Services?
The Grand Ole Docs Of The Southside, Llc has been assigned the NPI (National Provider Identifier) 1871693994 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Grand Ole Docs Of The Southside, Llc?
The Grand Ole Docs Of The Southside, Llc is situated at 1350 E County Line Rd, in the city of Indianapolis, state of IN, with the zip code 462270873.
What is Grand Ole Docs Of The Southside, Llc's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Grand Ole Docs Of The Southside, Llc is Family Medicine, and the taxonomy classification code that categorizes this area of expertise is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1871693994 to Grand Ole Docs Of The Southside, Llc?
The Centers for Medicare & Medicaid Services originally issued the 1871693994 to Grand Ole Docs Of The Southside, Llc on 2006-09-25.
As of what date were the details pertaining to Grand Ole Docs Of The Southside, Llc last refreshed?
The information related to the Grand Ole Docs Of The Southside, Llc, including its address, specialty, and other relevant details, was last updated on 2013-12-05.