Bloomington Ent Pc

NPI 1306816665 - Otolaryngology - 207Y00000X

NPI Details
NPI 1306816665
Enumeration Date 01/26/2006
Last Updated 04/15/2008
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JESSE JESSE
Position OWNER
Phone (812) 335-1300
Fax (812) 335-0300
Practice Location
1791 W 3RD ST
BLOOMINGTON IN, 47404-5029, US
Phone (812) 335-1300
Fax (812) 335-0300
Business Location
1791 W 3RD ST
BLOOMINGTON IN, 47404-5029, US
Phone (812) 335-1300
Fax (812) 335-0300
Toxanomy
Taxonomy Code 207Y00000X
License State Indiana
License Number 01040385A
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According to our database, Bloomington Ent Pc NPI is 1306816665, taxonomy code is 207Y00000X and license number is 01040385A, license state is located at Indiana. Bloomington Ent Pc physically located at 1791 W 3rd St, Bloomington IN, 47404-5029. NPI Number 1033115704 has the healthcare provider type.

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1306816665 NPI number is provided on an as is basis without warranty of any kind. 1306816665 is maintained by the National Plan & Provider Enumeration System. The contents of Bloomington Ent Pc are for informational purposes only.