Provider Demographics
NPI:1922071638
Name:INDIANA GERIATRIC ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:INDIANA GERIATRIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WERNERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-566-9905
Mailing Address - Street 1:38 TWINSHORE CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-3642
Mailing Address - Country:US
Mailing Address - Phone:317-566-9904
Mailing Address - Fax:
Practice Address - Street 1:38 TWINSHORE CT
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-3642
Practice Address - Country:US
Practice Address - Phone:317-566-9904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN149980Medicare ID - Type Unspecified