Southern Indiana Medical Group

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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