Provider Demographics
NPI:1235550922
Name:INDIANA EMERGENCY PHYSICIANS, LLP
Entity Type:Organization
Organization Name:INDIANA EMERGENCY PHYSICIANS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLP MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DERIK
Authorized Official - Middle Name:K
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-916-5259
Mailing Address - Street 1:1941 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-2833
Mailing Address - Country:US
Mailing Address - Phone:765-825-5131
Mailing Address - Fax:
Practice Address - Street 1:75 REMIT DR
Practice Address - Street 2:SUITE 1122
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60675-1122
Practice Address - Country:US
Practice Address - Phone:866-916-5259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty