Provider Demographics
NPI:1457708000
Name:UNION ASSOCIATED PHYSICIANS CLINIC, LLC
Entity Type:Organization
Organization Name:UNION ASSOCIATED PHYSICIANS CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REV CYC DIR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-232-0564
Mailing Address - Street 1:221 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-4214
Mailing Address - Country:US
Mailing Address - Phone:812-232-0564
Mailing Address - Fax:812-242-3861
Practice Address - Street 1:1711 N 6TH 1/2 ST STE 302
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-2770
Practice Address - Country:US
Practice Address - Phone:812-242-3005
Practice Address - Fax:812-242-3054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty