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Contact Information

DAVID J LICINI, MD
1302 S ROGERS ST
BLOOMINGTON, IN47403-4752
 Phone: 812-333-2663
 Fax: 812-676-4131
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Adult Reconstructive Orthopaedic Surgery

207XS0114X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for DAVID J LICINI · (Male)

NPI # 1801086343
Status Active
Credentials MD
Entity Individual
Enumeration date 07/31/2007
Last updated 10/27/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01071339A
  • IN Medicaid 201119230
Hospital affiliation(s)
  • COLUMBUS REGIONAL HOSPITAL - (Acute Care)
    2400 E 17TH ST
    COLUMBUS, IN 47201
  • INDIANA UNIVERSITY HEALTH - (Acute Care)
    1701 N SENATE BLVD
    INDIANAPOLIS, IN 46202
  • INDIANA UNIVERSITY HEALTH BEDFORD HOSPITAL - (Critical Access)
    2900 W 16TH ST
    BEDFORD, IN 47421
  • INDIANA UNIVERSITY HEALTH BLOOMINGTON HOSPITAL - (Acute Care)
    601 W SECOND ST
    BLOOMINGTON, IN 47403
  • INDIANA UNIVERSITY HEALTH PAOLI HOSPITAL - (Critical Access)
    642 W HOSPITAL RD
    PAOLI, IN 47454
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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