Bloomington Obstetrics And Gynecology, LLC
Obstetrics & Gynecology in Bloomington, IN. Organization (NPI-2).
NPI number1760427397
StatusActive
Last updated in NPPESOct 26, 2007
Details
- NPI
- 1760427397
- Entity type
- Organization (NPI-2)
- Legal business name
- Bloomington Obstetrics And Gynecology, LLC
- Organization subpart
- No
- Enumeration date
- Jun 18, 2006
- Last updated
- Oct 26, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | – | – | Yes |
Practice location
421 W 1st StBloomington, IN 47403-2403
Phone 812-336-0168 · Fax 812-355-7372
Mailing address
421 W 1st StBloomington, IN 47403-2403
Phone 812-336-0168 · Fax 812-335-7372
Authorized official
Leland R Matthews
Partner
8123360168
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