Basic Information
Provider Information
NPI: 1851331268
EntityType: 2
ReplacementNPI:  
OrganizationName: ST. FRANCIS HOSPITAL & HEALTH CENTERS
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CENTER GROVE FAMILY MEDICINE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 663759
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462663759
CountryCode: US
TelephoneNumber: 3177803333
FaxNumber: 3177803345
Practice Location
Address1: 362 MERIDIAN PARKE LN
Address2:  
City: GREENWOOD
State: IN
PostalCode: 461429425
CountryCode: US
TelephoneNumber: 3178593737
FaxNumber: 3178593730
Other Information
ProviderEnumerationDate: 06/07/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MURPHY
AuthorizedOfficialFirstName: JOHN
AuthorizedOfficialMiddleName: L
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 3177813604
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home