Provider Demographics
NPI:1952331084
Name:ST. FRANCIS HOSPITAL AND HEALTH CENTERS
Entity Type:Organization
Organization Name:ST. FRANCIS HOSPITAL AND HEALTH CENTERS
Other - Org Name:SOUTHPORT FAMILY PRACTICE & SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-781-3604
Mailing Address - Street 1:PO BOX 664057
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46266-4057
Mailing Address - Country:US
Mailing Address - Phone:317-780-3333
Mailing Address - Fax:317-780-3345
Practice Address - Street 1:7855 S EMERSON AVE
Practice Address - Street 2:SUITE P
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8668
Practice Address - Country:US
Practice Address - Phone:317-888-5500
Practice Address - Fax:317-887-4806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN187350Medicare ID - Type Unspecified