American Health Network of Indiana, LLC
Organization Active NPI Hematology & Oncology Physician · Madison, IN
NPI 1861579161 · NPPES record last updated Jan 9, 2008
Key facts
- NPI
- 1861579161
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- Legal business name
- AMERICAN HEALTH NETWORK OF INDIANA, LLC
- Practice address
- 1 Kings Daughters Dr
Madison, IN 47250-3300 - Phone
- (812) 265-5211
- NPI assigned
- Nov 1, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- AMERICAN HEALTH NETWORK OF INDIANA, LLC
Authorized official
- Name
- Ben H Park, MD
- Title
- President and Ceo
- Phone
- (317) 580-6309
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031124000691 | IN | Part B Supplier - Clinic/Group Practice | 9830093533 |
Receives reassigned benefits from 230 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- American Health Network LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician |
207RH0003X | Yes |
Addresses
Primary practice location
1 Kings Daughters Dr
Madison, IN 47250-3300
Mailing address
PO Box 660242
Indianapolis, IN 46266-0001
Phone (812) 265-5211
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All providers in Madison, IN · Hematology & Oncology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.