RDM SURGICAL ASSISTANT
NPI 1265054712
Physician Assistant - Surgical in Depauw, IN
Active since May 07, 2020
About Rdm Surgical Assistant NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RDM SURGICAL ASSISTANT (NPI 1265054712) is a healthcare organization registered as a surgical in Depauw, Indiana and active in the NPI registry since May 2020. The organization lists Rebecca Lou Autry, Owner, as its authorized official.
NPPES Registry Identity
NPI1265054712
Entity TypeOrganization
Primary Taxonomy363AS0400X
Legal Business NameRDM SURGICAL ASSISTANT
Location Address10081 FREDERICKSBURG RD NWDepauw, IN 47115-8629
Mailing Address10081 Fredericksburg Rd NwDepauw, IN 47115-8629 · (812) 267-6695
Phone(812) 267-6695
Organization SubpartNo
Authorized OfficialRebecca Lou AutryOwner · (812) 267-6695
Enumeration DateMay 7, 2020
Last NPPES UpdateJune 4, 20202 updates tracked since enumeration
NPPES CertifiedJune 4, 2020
✔ NPI 1265054712 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
10081 FREDERICKSBURG RD NW, Depauw, IN 47115
Group Practice 1
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265054712, enumerated as an "organization" on May 07, 2020.
The provider is located at 10081 FREDERICKSBURG RD NW DEPAUW, IN 47115 and the phone number is (812) 267-6695.
Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.
