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Contact Information

MOBILE MEDICAL PROVIDER INC
12045 BODLEY PLACE
FISHERS, IN46037-3714
 Phone: 317-588-1039
 Fax: 317-436-7002
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Family

363LF0000X 50 Nurse Practitioner
 

Hospice and Palliative Medicine

207QH0002X 08 Physician/Family Practice
 

Hospice and Palliative Medicine

207RH0002X 11 Physician/Internal Medicine
 

Hospice and Palliative Medicine

2084H0002X 17 Physician/Hospice and Palliative Care
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MOBILE MEDICAL PROVIDER INC

NPI # 1659768356
LBN Legal business name MOBILE MEDICAL PROVIDER INC
Authorized official ADESHOLA AFOLABI - (PRESIDENT/CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 04/20/2015
Last updated 08/14/2020 - About 6 years ago
Identifiers
IN License # 28204676A
IN Medicaid 201176490
IN Other 000000826011 ANTHEM
IN Other 12544963 CAQH
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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