Provider Demographics
NPI:1073857793
Name:PHYSICIANS PRACTICE ORGANIZATION INC
Entity Type:Organization
Organization Name:PHYSICIANS PRACTICE ORGANIZATION INC
Other - Org Name:DBA NEUROLOGY AND SLEEP SCIENCES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALESSI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:812-988-2223
Mailing Address - Street 1:PO BOX 2547
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47202-2547
Mailing Address - Country:US
Mailing Address - Phone:812-376-3100
Mailing Address - Fax:812-378-6191
Practice Address - Street 1:1655 N GLADSTONE AVE STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5380
Practice Address - Country:US
Practice Address - Phone:812-376-3100
Practice Address - Fax:812-378-6191
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHYSICIANS PRACTICE ORGANIZATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-19
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INDT5944OtherRAILROAD MEDICARE
IN201130060Medicaid
ININ1105Medicare PIN
INDT5944OtherRAILROAD MEDICARE