Basic Information
| Provider Information | |||||||||
| NPI: | 1720099153 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOOSIER ANESTHESIA ASSOCIATES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 643179 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452643179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372930247 | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 WILSON CREEK ROAD | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 470252751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8125371010 | ||||||||
| FaxNumber: | 8129263209 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2006 | ||||||||
| LastUpdateDate: | 09/22/2015 | ||||||||
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| AuthorizedOfficialLastName: | UEHLEIN | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5132658404 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 000000029690 | 01 | IN | ANTHEM | OTHER | 0623678 | 05 | OH | MEDICAID | 100093800 | 05 | IN | MEDICAID | CB3153 | 01 | IN | RAILROAD MEDICARE | OTHER |