Provider Demographics
NPI:1700934916
Name:SURGICAL ASSOCIATES OF SOUTHEASTERN INDIANA, P.C.
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES OF SOUTHEASTERN INDIANA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-934-4262
Mailing Address - Street 1:222 STATE ROAD 129 S
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-7694
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 STATE ROAD 129 S
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-7694
Practice Address - Country:US
Practice Address - Phone:812-934-4262
Practice Address - Fax:812-934-4298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50003165A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INDA701240AMedicare ID - Type Unspecified
INE05800Medicare UPIN