Provider Demographics
NPI:1265939656
Name:INDIANA HERNIA CENTER, LLC
Entity type:Organization
Organization Name:INDIANA HERNIA CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SZOTEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-660-5262
Mailing Address - Street 1:2937 GADSEN CIR S
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8393
Mailing Address - Country:US
Mailing Address - Phone:317-868-1305
Mailing Address - Fax:317-645-1477
Practice Address - Street 1:8435 CLEARVISTA PL STE 104
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3761
Practice Address - Country:US
Practice Address - Phone:317-868-1305
Practice Address - Fax:317-645-1477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01063653A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty