Grand Ole Docs of the Southside, LLC
Grand Ole Docs of the Southside, LLC provides Family Medicine Physician services in Indianapolis, Indiana. Licensed in Indiana. Registered with an NPI since 2007.
- Licensed in
- IN
- In the registry since
- 2007
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
6349 S East StIndianapolis, IN 46227-7107 Not confirmed with CMS for 12 years — call before visiting
Phone: (317) 807-0247
Fax: (317) 735-1951
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence 01036126A (IN) |
|---|
Record details
| NPI number | 1639359037 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jeffrey Dewester — Owner · (317) 807-0247 |
| Other names | Central Indiana Medical Group |
| NPI enumerated | November 14, 2007 |
| Last updated in NPPES | December 5, 2013 |
| Mailing address | 1350 E County Line Rd, Suite H, Indianapolis, IN 46227-0873 |
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Grand Ole Docs of the Southside
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Grand Ole Docs of the Southside, LLC
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Alycia Valerie Graves, FNP-C
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Alise Green
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