Provider Demographics
NPI:1548212798
Name:INDIANA PATHOLOGY INSTITUTE PC
Entity Type:Organization
Organization Name:INDIANA PATHOLOGY INSTITUTE PC
Other - Org Name:UNIVERSITY CLINICAL PATHOLOGY ASSOCIATES PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:N
Authorized Official - Last Name:EBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-274-4806
Mailing Address - Street 1:635 BARNHILL DR
Mailing Address - Street 2:A128
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5126
Mailing Address - Country:US
Mailing Address - Phone:317-274-4806
Mailing Address - Fax:
Practice Address - Street 1:635 BARNHILL DR
Practice Address - Street 2:A128
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5126
Practice Address - Country:US
Practice Address - Phone:317-274-4806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty