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Grand Ole Docs Of The Southside, Llc
Family Medicine Physician in Indianapolis, Indiana
NPI 1639359037

Grand Ole Docs Of The Southside, Llc is a Family Medicine Physician based in Indianapolis, IN. Grand Ole Docs Of The Southside, Llc practices in Indianapolis, IN. The NPI Number for Grand Ole Docs Of The Southside, Llc is 1639359037 and holds a License No. 01036126A (Indiana).

The current practice location address for Grand Ole Docs Of The Southside, Llc is 6349 S East St, Indianapolis, IN and can be reached out via phone at 317-807-0247 and via fax at 317-735-1951.

Location: 6349 S East St, Indianapolis, IN, 46227-0873
institution
Provider Profile Details
NPI Number
1639359037
Provider Name
Grand Ole Docs Of The Southside, Llc
Credential
Provider Entity Type
Organization
Address
6349 S East St, Indianapolis, IN, 46227-0873
Phone Number
317-807-0247
Fax Number
317-735-1951
Provider Enumeration Date
11/14/2007
Last Update Date
02/15/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
CI4722 01 IN GROUP RR MEDICARE #
5457630005 01 IN DME
institution
Provider Business Practice Location Address Details
Address
6349 S East St
City
State
Zip
46227-7107
Phone Number
317-807-0247
Fax Number
317-735-1951
person
Provider Business Mailing Address Details
Address
6349 S East St
City
State
Zip
46227-7107
Phone Number
317-807-0247
Fax Number
317-735-1951
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
License No.
01036126A (Indiana)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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