Small, George Robert

Small, George Robert is an individual health care provider with primary practice located at 284 N Madison Ave , Greenwood IN 46142-3634. He recently has only one registered license in Other Service Providers / Legal Medicine, which is considered as his primary health care specialty. Small, George Robert can be contacted via phone (317) 888-7745.

Contact Information

Primary practice address
284 N Madison Ave Greenwood IN 46142-3634
Phone: (317) 888-7745
Fax: (317) 865-9007
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X 01022870A Indiana

Profile Details

NPI number 1194815449
LBN Legal business name Small, George Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2006
Last updated Sep 15th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194815449 NPPES
Indiana MEDICAID 100151110A
Indiana Other 11068524/DF4194
Indiana Other 17300000X
Indiana Other 87581
Indiana Other 1245495142
Indiana Other 232590A

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