| Organization Name: | HAZEL DELL PEDIATRAICS, LLC |
| NPI Number: | 1033326376 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CATHERINE J LUCE (OFFICE MANAGER) |
| Mailing Address: | 13250 Hazel Dell Pkwy Suite 103 Carmel |
| State: | IN US |
| Postal Code: | 460338521 |
| Phone Number: | 3178439475 |
| Fax Number: | 3178439476 |
| NPI Enumeration Date: | 05/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |