Basic Information
| Provider Information | |||||||||
| NPI: | 1891821591 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HAMILTION INPATIENT PHYSICIANS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 176 LOGAN ST | ||||||||
| Address2: | # 368 | ||||||||
| City: | NOBLESVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460601437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176791123 | ||||||||
| FaxNumber: | 3177702793 | ||||||||
| Practice Location | |||||||||
| Address1: | 395 WESTFIELD RD | ||||||||
| Address2: | |||||||||
| City: | NOBLESVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460601425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3177730760 | ||||||||
| FaxNumber: | 3177702793 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2007 | ||||||||
| LastUpdateDate: | 06/10/2015 | ||||||||
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| AuthorizedOfficialLastName: | PENCE | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3177730760 | ||||||||
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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 | 282N00000X | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 200352370A | 05 | IN | MEDICAID |