Provider Demographics
NPI:1013130764
Name:INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC
Entity Type:Organization
Organization Name:INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC
Other - Org Name:IU HEALTH TIPTON HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM CFO, VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-675-8507
Mailing Address - Street 1:1000 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:IN
Mailing Address - Zip Code:46072-9753
Mailing Address - Country:US
Mailing Address - Phone:765-675-8500
Mailing Address - Fax:765-675-8520
Practice Address - Street 1:1000 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TIPTON
Practice Address - State:IN
Practice Address - Zip Code:46072-9753
Practice Address - Country:US
Practice Address - Phone:765-675-8500
Practice Address - Fax:765-675-8520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000603373OtherANTHEM ER
IN200933330Medicaid
IN000000603584OtherANTHEM - CARDIOLOGY
IN000000603595OtherANTHEM - CRNA
IN000000603573OtherANTHEM - ORTHOPEDICS
IN000000603582OtherANTHEM - PATHOLOGY
IN000000603373OtherANTHEM - ER
IN200933330Medicaid