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VIDA ONCOLOGY LLC NPI 1659987832


NPI Information

NPI: 1659987832
Provider Name: VIDA ONCOLOGY LLC
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

CLIA Number: 15D2214426

Address:
2150 INTELLIPLEX DR STE 134
SHELBYVILLE, IN
ZIP 46176
Phone: (317) 796-2200
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VIDA ONCOLOGY LLC is a hematology and oncology internal medicine in Shelbyville, IN. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. VIDA ONCOLOGY LLC NPI is 1659987832. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2150 INTELLIPLEX DR STE 134
SHELBYVILLE, IN
ZIP 46176-550
Phone: (317) 796-2200

The provider's authorized official is Jaime Ayon .
The authorized official title is Owner and has the following contact phone number (317) 796-2200.

The CLIA number assigned to this NPI record is 15D2214426 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/22/2020 and was last updated on 9/22/2020.


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
1207RH0003XInternal MedicineHematology & OncologyYes

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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