Unknown Individual – Family Medicine Physician, NPI 1023056868
Family Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
4780, Briar Gate Court, Bloomington, Monroe County, Indiana, 47404, United States
BLOOMINGTON, IN 474024780
Phone: (812) 336-1690
Fax: (812) 349-1311
Type: Mailing
5210, East Thompson Road, Indianapolis, Marion County, Indiana, 46237, United States
INDIANAPOLIS, IN 462372085
Phone: (317) 899-5546
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 47402)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TN | |
| - | VA | |
| A N E S T H E S I O L O G Y | IN | |
| - | TN | |
| - | NM | |
| - | WI | |
| Physician Assistant | PA | |
| - | OH | |
| Physician Assistant | NV | |
| Nurse Practitioner | FL |
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