Provider Demographics
NPI:1952955056
Name:PREFERRED INJURY PHYSICIANS LLC
Entity Type:Organization
Organization Name:PREFERRED INJURY PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:WAELDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-459-4959
Mailing Address - Street 1:7145 E VIRGINIA ST STE 2000
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-9147
Mailing Address - Country:US
Mailing Address - Phone:812-962-7890
Mailing Address - Fax:
Practice Address - Street 1:2700 OLD ROSEBUD RD STE 330
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-8630
Practice Address - Country:US
Practice Address - Phone:812-962-7890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty