OrganizationActive
Southern Indiana Family Practice Center PC
NPI 1770626152 · Preferred Provider Organization · Bloomington, IN
Provider details
- NPI number
- 1770626152
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Karen Reid-Renner, Owner(812) 339-6744
- License
- 71002130A (IN)
Specialties & taxonomies
Managed Care Organizations
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3209 W Fullerton Pike
Ste a
Bloomington, IN 47403-4060
Phone: (812) 339-6744
Fax: (812) 671-9113
Approximate (ZIP-level) locationGet directions
Mailing address
3209 W Fullerton Pike
Bloomington, IN 47403-4060
Other names (DBA / former)
- Doing business as
- Southern Indiana Family Practice Center
Registry dates
- Enumerated
- 2007-02-15
- Last updated
- 2015-11-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.