NPI Provider: 1013953983
Contact Name: Fishel B Marlon
Position: Administrator
Phone: (812) 353-5858
Southern Indiana Medical Group Information:
Southern Indiana Medical Group organization have npi 1013953983, taxonomy code is 261QP2300X with license number is in . This Business address located in PO Box 1329, Bloomington, IN 47402 Indiana.
Practice Location
Address: 210 E Winslow Rd, Bloomington, IN 47401
Phone: (812) 353-5855
Business Location
Address: PO Box 1329, Bloomington, IN 47402
Phone: (812) 353-5858
Fax: (812) 353-5867
Taxonomy
Taxonomy Code: 261QP2300X
License Number:
License Number of State:
Primary Taxonomy Switch: Y
Enumeration Date: 6/21/2006
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