Provider Demographics
NPI:1205189420
Name:UNIVERSITY SURGEONS, INC
Entity Type:Organization
Organization Name:UNIVERSITY SURGEONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECTION DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:SELZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-274-3086
Mailing Address - Street 1:545 BARNHILL DR
Mailing Address - Street 2:EH 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:545 BARNHILL DR
Practice Address - Street 2:EH 500
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5112
Practice Address - Country:US
Practice Address - Phone:317-274-3086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004150A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty