Central Indiana Medical Group

LBN: Grand Old Docs Of The Southside
Central Indiana Medical Group is an health care organization with primary practice located at 134 N Emerson Ave , Greenwood IN 46143-9760. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Grand Old Docs Of The Southside can be contacted via phone (317) 882-7344, or through Duggan, Donald E via phone (317) 882-7344.

Contact Information

Primary practice address
134 N Emerson Ave Greenwood IN 46143-9760
Phone: (317) 882-7344
Fax: (317) 882-4793
Website:
Map and Directions
Authorized official contact:
Name: Duggan, Donald E Doctor of Medicine (MD)
Phone: (317) 882-7344

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1942396890
LBN Legal business name Grand Old Docs Of The Southside
DBA Doing business as Central Indiana Medical Group
Authorized official Duggan, Donald E Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 5th, 2006
Last updated Sep 10th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942396890 NPPES
Indiana Other CI4722 GROUP RR MEDICARE NUMBER
Indiana Other 5457630004 GROUP RR MEDICARE NUMBER

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