Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Grand Old Docs of the Southside

Organization Family Medicine Physician · NPI 1790886844

Grand Old Docs of the Southside provides Family Medicine Physician services in Greenwood, Indiana. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

360 S Madison Ave #200
Greenwood, IN 46142-3150 Not confirmed with CMS for 18 years — call before visiting
Phone: (317) 865-9090
Fax: (317) 865-0523
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1790886844
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brenda Russell — Physician · (317) 865-9090
Other names Central Indiana Medical Group
NPI enumeratedSeptember 25, 2006
Last updated in NPPESJune 30, 2008
Mailing address1350 E County Line Rd, Suite I, Indianapolis, IN 46227-0873

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