Provider Demographics
NPI:1669685491
Name:ACCUDOC INC PC
Entity Type:Organization
Organization Name:ACCUDOC INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:R
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-932-3224
Mailing Address - Street 1:20 ALPINE DR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-8477
Mailing Address - Country:US
Mailing Address - Phone:812-932-3224
Mailing Address - Fax:
Practice Address - Street 1:20 ALPINE DR
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-8477
Practice Address - Country:US
Practice Address - Phone:812-932-3224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048884A261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000336036OtherANTHEM GROUP NUMBER
IN000000504434OtherANTHEM SERVICE LOCATION
INH06655Medicare UPIN
IN000000504434OtherANTHEM SERVICE LOCATION