Provider Demographics
NPI:1275852477
Name:INDIANA UNIVERSITY HEALTH BALL MEMORIAL PHYSICIANS, INC.
Entity Type:Organization
Organization Name:INDIANA UNIVERSITY HEALTH BALL MEMORIAL PHYSICIANS, INC.
Other - Org Name:BALL STATE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:L
Authorized Official - Last Name:VANETS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-751-5404
Mailing Address - Street 1:221 N CELIA AVE
Mailing Address - Street 2:ATTN: DEBERA BARKER
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-4609
Mailing Address - Country:US
Mailing Address - Phone:765-282-8905
Mailing Address - Fax:
Practice Address - Street 1:1500 NEELY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47306-0001
Practice Address - Country:US
Practice Address - Phone:765-285-8431
Practice Address - Fax:765-285-1103
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A PARTNER WITH IU HEALTH BALL MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-27
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty