Provider Demographics
NPI:1881276004
Name:COMMUNITY HEALTH NETWORK
Entity type:Organization
Organization Name:COMMUNITY HEALTH NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-355-5822
Mailing Address - Street 1:8890 E 116TH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2856
Mailing Address - Country:US
Mailing Address - Phone:317-621-1663
Mailing Address - Fax:317-621-1668
Practice Address - Street 1:8890 E 116TH ST STE 130
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2856
Practice Address - Country:US
Practice Address - Phone:317-621-1663
Practice Address - Fax:317-621-1668
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HEALTH NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty