Basic Information
| Provider Information | |||||||||
| NPI: | 1174515415 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BITTENBENDER & BITTENBENDER, L.L.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2315 GREEN VALLEY RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | NEW ALBANY | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471504649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8129452100 | ||||||||
| FaxNumber: | 8129459495 | ||||||||
| Practice Location | |||||||||
| Address1: | 2315 GREEN VALLEY RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | NEW ALBANY | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471504649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8129452100 | ||||||||
| FaxNumber: | 8129459495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | BITTENBENDER | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | WILLIAM | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8129452100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | IN | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | CJ2736 | 01 | RAILROAD MEDICARE | OTHER |