Provider Demographics
NPI:1508156811
Name:PHYSICIANS' PRACTICE ORGANIZATION, INC
Entity Type:Organization
Organization Name:PHYSICIANS' PRACTICE ORGANIZATION, INC
Other - Org Name:SOUTHEASTERN INDIANA CANCER CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RALPH
Authorized Official - Last Name:ALESSI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:812-373-3024
Mailing Address - Street 1:411 PLAZA DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-2916
Mailing Address - Country:US
Mailing Address - Phone:812-373-3024
Mailing Address - Fax:
Practice Address - Street 1:2400 17TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5351
Practice Address - Country:US
Practice Address - Phone:812-373-3024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01068313A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty