| Organization Name: | IU HEALTH BALL MEMORIAL PHYSICIANS BLACKFORD |
| NPI Number: | 1154799989 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS LEE (PHYSICIAN) |
| Mailing Address: | 400 Pilgrim Blvd Hartford City |
| State: | IN US |
| Postal Code: | 473481382 |
| Phone Number: | 7653485776 |
| Fax Number: | 7653483088 |
| NPI Enumeration Date: | 09/10/2015 |
| NPI Last Update Date: | 09/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 28192064A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |