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PREMISE HEALTH OF INDIANA MEDICAL P.C. NPI 1114588233


NPI Information

NPI: 1114588233
Provider Name: PREMISE HEALTH OF INDIANA MEDICAL, P.C.

Doing Business As: CAESARS HEALTH CENTER HOOSIER PARK ANDERSON

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 15D2168849

Address:
4500 DAN PATCH CIR
ANDERSON, IN
ZIP 46013
Phone: (765) 609-4711
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PREMISE HEALTH OF INDIANA MEDICAL, P.C. is a multi-specialty clinic center in Anderson, IN. PREMISE HEALTH OF INDIANA MEDICAL, P.C. NPI is 1114588233. The provider is registered as an organization entity type.
The provider Is Doing Business As Caesars Health Center Hoosier Park Anderson.

The provider's business location address is:

4500 DAN PATCH CIR
ANDERSON, IN
ZIP 46013-165
Phone: (765) 609-4711
Fax: (765) 609-4713

The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 15D2168849 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/28/2019 and was last updated on 8/25/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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