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Contact Information

ATHELITE ORTHOPEDICS AND SPORTS MEDICINE, LLC
365 S PARK RIDGE RD
SUITE 102
BLOOMINGTON, IN47401-8361
 Phone: 812-822-2675
 Fax: 812-822-2679
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for ATHELITE ORTHOPEDICS AND SPORTS MEDICINE LLC · (Female)

NPI # 1417287970
Status Active
Credentials
Entity Individual
Enumeration date 01/06/2010
Last updated 01/06/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 1052068
  • IN Medicaid 200272920
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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