Provider Demographics
NPI:1184181331
Name:REGENERATIVE HEALTH INSTITUTE P.C.
Entity Type:Organization
Organization Name:REGENERATIVE HEALTH INSTITUTE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-993-3361
Mailing Address - Street 1:20 EXECUTIVE DR STE A
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2988
Mailing Address - Country:US
Mailing Address - Phone:317-993-3361
Mailing Address - Fax:317-993-3362
Practice Address - Street 1:20 EXECUTIVE DR STE A
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2988
Practice Address - Country:US
Practice Address - Phone:317-993-3361
Practice Address - Fax:317-993-3362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty