American Health Network of Indiana, LLC

Organization Active NPI Foot & Ankle Surgery Podiatrist · Noblesville, IN

NPI 1992721088 · NPPES record last updated Jan 9, 2008

Key facts

NPI
1992721088
Entity type
Organization (NPI type 2)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Practice address
18051 River Ave
Suite 200
Noblesville, IN 46062-7091
Phone
(317) 773-0002
Fax
(317) 776-6095
NPI assigned
Jul 14, 2006
Organization subpart
Yes
Parent organization (as reported)
AMERICAN HEALTH NETWORK OF INDIANA, LLC

Authorized official

Name
Ben H Park, M.D.
Title
President and Ceo
Phone
(317) 580-6307

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP
213ES0103X Yes

Addresses

Primary practice location

18051 River Ave
Suite 200
Noblesville, IN 46062-7091

Mailing address

18051 River Ave
Suite 200
Noblesville, IN 46062-7091
Phone (317) 773-0002

Other identifiers

IdentifierTypeStateIssuer
0828280001OtherINDMERC

Other providers in Noblesville, IN

All providers in Noblesville, IN · Foot & Ankle Surgery Podiatrist in Indiana

Sources for this page

Verify at the official NPI Registry.