NPI 1184855272

Ima East Primary Care

Organisation Sports Medicine (Family Medicine) Physician Bloomington, IN

Practice location

Address: 2605 E Creeks Edge Dr, Bloomington, IN 47401-8368
Phone: (812) 355-2300
Fax: (812) 355-3251
Mailing address: 550 S Landmark Ave, Bloomington, IN 47403-3239

Authorised official

Name: Wesley W Ratlif
Title: President
Phone: (812) 331-3400

Registered specialties

Sports Medicine (Family Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207QS0010X Licence 01066805A (IN)

Other Family Medicine providers in Indiana →

Registry record

NPI: 1184855272
Entity type: Organization
NPI issued: 6 Aug 2009
Record last updated: 14 Jan 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.