Provider Demographics
NPI:1124441332
Name:ACCESS 2 MD LLC
Entity type:Organization
Organization Name:ACCESS 2 MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-550-0027
Mailing Address - Street 1:5105 S US HIGHWAY 41
Mailing Address - Street 2:SUITE 175
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4790
Mailing Address - Country:US
Mailing Address - Phone:844-222-3772
Mailing Address - Fax:844-222-3772
Practice Address - Street 1:5105 S US HIGHWAY 41
Practice Address - Street 2:SUITE 175
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4790
Practice Address - Country:US
Practice Address - Phone:844-222-3772
Practice Address - Fax:844-222-3772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty