Provider Demographics
NPI:1902359128
Name:OURHEALTH PHYSICIANS GROUP, LLC
Entity Type:Organization
Organization Name:OURHEALTH PHYSICIANS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-559-2055
Mailing Address - Street 1:4151 E 96TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1442
Mailing Address - Country:US
Mailing Address - Phone:317-559-2055
Mailing Address - Fax:
Practice Address - Street 1:600 E 84TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6366
Practice Address - Country:US
Practice Address - Phone:317-559-2055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care