Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grand Ole Docs of the Southside, LLC

Organization Family Medicine Physician · NPI 1477653509

Grand Ole Docs of the Southside, LLC is a Family Medicine Physician in Greenwood, Indiana. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

365 E Main St
Greenwood, IN 46143-1361
Phone: (317) 881-5152
Fax: (317) 881-8993
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1477653509
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Richert — Md · (317) 881-5152
Other names Central Indiana Medical Group
NPI enumeratedSeptember 25, 2006
Last updated in NPPESDecember 5, 2013
Mailing address1350 E County Line Rd, Suite H, Indianapolis, IN 46227-0873

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