Provider Demographics
NPI:1083675656
Name:JOINT REPLACEMENT SURGEONS OF INDIANA
Entity Type:Organization
Organization Name:JOINT REPLACEMENT SURGEONS OF INDIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-831-2273
Mailing Address - Street 1:1199 HADLEY RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-1788
Mailing Address - Country:US
Mailing Address - Phone:317-831-2273
Mailing Address - Fax:317-831-9347
Practice Address - Street 1:1199 HADLEY RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-1788
Practice Address - Country:US
Practice Address - Phone:317-831-2273
Practice Address - Fax:317-831-9347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000188520OtherANTHEM
IN2065256OtherUNITED HEALTHCARE
IN4178250001Medicare NSC
IN000000188520OtherANTHEM