Western Indiana Physicians LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

WESTERN INDIANA PHYSICIANS LLC

Practice address

801 S Main St
Clinton, IN 47842-2261

Phone

(770) 874-5439

Fax

(770) 874-5483

NPI assigned

Jan 25, 2012

Last updated

Sep 8, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Preston Williams Smith

Title

Chief Revenue Officer

Phone

(770) 874-5400

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1730450560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR NW",
            "address_2": "SUITE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831",
            "telephone_number": "770-874-5439",
            "fax_number": "770-874-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S MAIN ST",
            "city": "CLINTON",
            "state": "IN",
            "postal_code": "478422261",
            "telephone_number": "770-874-5439",
            "fax_number": "770-874-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN INDIANA PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PRESTON",
        "authorized_official_middle_name": "WILLIAMS",
        "authorized_official_title_or_position": "CHIEF REVENUE OFFICER",
        "authorized_official_telephone_number": "770-874-5400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Clinton, IN
• Providers in Clinton, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.