Provider Demographics
NPI:1871222422
Name:INDIANA JOINT REPLACEMENT INSTITUTE
Entity type:Organization
Organization Name:INDIANA JOINT REPLACEMENT INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MENEGHINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-620-0232
Mailing Address - Street 1:3834 S EMERSON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-5902
Mailing Address - Country:US
Mailing Address - Phone:317-620-0232
Mailing Address - Fax:260-208-9561
Practice Address - Street 1:1721 MAGNAVOX WAY STE B
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-1537
Practice Address - Country:US
Practice Address - Phone:317-620-0232
Practice Address - Fax:260-208-9561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty