1154349827 NPI number — SOUTHERN INDIANA ANESTHESIA CONSULTANTS, PLLC

Table of content: (NPI 1154349827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154349827 NPI number — SOUTHERN INDIANA ANESTHESIA CONSULTANTS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHERN INDIANA ANESTHESIA CONSULTANTS, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154349827
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 70101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40270-0101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-690-8782
Provider Business Mailing Address Fax Number:
502-459-0923

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1850 STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ALBANY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47150-4990
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-690-8782
Provider Business Practice Location Address Fax Number:
502-459-0923
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
BARRY
Authorized Official Middle Name:
H
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
502-690-8782

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000064676 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000064676 . This is a "ANTHEM" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 2441627000 . This is a "PASSPORT ADVANTAGE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000064676 . This is a "HEALTHLINK" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200230600A . This is a "MANAGED HEALTH SERVICES" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200230600A . This is a "MDWISE HOOSIER ALLIANCE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000064676 . This is a "UNICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 129703800 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 134960 . This is a "UNICARE MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000064676 . This is a "INDIANA COMPREHENSIVE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000064676 . This is a "ANTHEM MEDICAID" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: CI9097 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000064676 . This is a "ONE NATION BENEFIT" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 129703800 . This is a "BLACK LUNG PROGRAM" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200230600A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com