Provider Demographics
NPI:1104181601
Name:INDIANA UNIVERSITY SCHOOL OF MEDICINE
Entity Type:Organization
Organization Name:INDIANA UNIVERSITY SCHOOL OF MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN HOUSE STAFF COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-656-4260
Mailing Address - Street 1:1001 W 10TH ST # M200
Mailing Address - Street 2:INDIANA UNIVERSITY DEPARTMENT OF DERMATOLOGY
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2859
Mailing Address - Country:US
Mailing Address - Phone:317-312-7030
Mailing Address - Fax:317-630-2667
Practice Address - Street 1:1001 W 10TH ST # M200
Practice Address - Street 2:INDIANA UNIVERSITY DEPARTMENT OF DERMATOLOGY
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2859
Practice Address - Country:US
Practice Address - Phone:317-312-7030
Practice Address - Fax:317-630-2667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11016587A282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital