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1500 N Ritter Ave Indianapolis IN 46219-3027 | |
| (317) 355-2223 | |
| (317) 355-2205 |
| Full Name | |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1500 N Ritter Ave, Indianapolis, Indiana |
| Authorized Official Name and Position | Thomas P Fischer (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3173554887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 19751 Indianapolis IN 46219-0751 Ph: (317) 355-2223 | 1500 N Ritter Ave Indianapolis IN 46219-3027 Ph: (317) 355-2223 |
| NPI Number | 1235213380 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235213380 | NPI | - | NPPES |
| CA6165 | Other | IN | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
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