Provider Demographics
NPI:1710932736
Name:MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BEVE
Authorized Official - Middle Name:P
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:260-341-1189
Mailing Address - Street 1:PO BOX 6276
Mailing Address - Street 2:DEPT 20
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-6276
Mailing Address - Country:US
Mailing Address - Phone:866-598-0158
Mailing Address - Fax:
Practice Address - Street 1:7150 CLEARVISTA DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1695
Practice Address - Country:US
Practice Address - Phone:317-355-5041
Practice Address - Fax:317-355-5693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100072340Medicaid
IN115450Medicare ID - Type UnspecifiedMCARE #