Provider Demographics
NPI:1922072933
Name:EASTERN INDIANA ORTHOPAEDICS INC
Entity Type:Organization
Organization Name:EASTERN INDIANA ORTHOPAEDICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-962-5574
Mailing Address - Street 1:1400 HIGHLAND RD
Mailing Address - Street 2:STE 1
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-8810
Mailing Address - Country:US
Mailing Address - Phone:765-962-5574
Mailing Address - Fax:765-939-4200
Practice Address - Street 1:1400 HIGHLAND RD
Practice Address - Street 2:STE 1
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-8810
Practice Address - Country:US
Practice Address - Phone:765-962-5574
Practice Address - Fax:765-939-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2557719Medicaid
OH0988614Medicaid
OHEA9356991Medicare PIN
IN904740Medicare PIN