Diane Jordan-wagner, MD | |
1429 N 6th St, Terre Haute, IN 47804-1037 | |
(812) 232-0564 | |
(812) 235-3330 |
Full Name | Diane Jordan-wagner |
---|---|
Gender | Female |
Speciality | Internal Medicine - Allergy & Immunology |
Location | 1429 N 6th St, Terre Haute, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013025097 | NPI | - | NPPES |
030005377 | Other | RAILROAD MCARE PALAMETTO | |
200392780 | Medicaid | IN | |
P00844293 | Other | IN | RAILROAD MEDICARE |
000000230225 | Other | ANTHEM | |
200392780Q | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RA0201X | Internal Medicine - Allergy & Immunology | 01056292A (Indiana) | Primary |
207RA0201X | Internal Medicine - Allergy & Immunology | 36106006 (Illinois) | Secondary |
Entity Name | Union Associated Physicians Clinic, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891028379 PECOS PAC ID: 3375687437 Enrollment ID: O20100213000002 |
Mailing Address | Practice Location Address |
---|---|
Diane Jordan-wagner, MD 221 S 6th St, Terre Haute, IN 47807-4214 Ph: (812) 232-0564 | Diane Jordan-wagner, MD 1429 N 6th St, Terre Haute, IN 47804-1037 Ph: (812) 232-0564 |
Carrie Ann Deakins, MSN, RN, FNP-BC Internal Medicine Medicare: Medicare Enrolled Practice Location: 3560 S 4th St, Terre Haute, IN 47802 Phone: 812-235-8496 | |
Casey E Jacobs-campbell, FNP-BC Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1801 N 6th St, Terre Haute, IN 47804 Phone: 812-238-4708 | |
Imad George Koj, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3903 S 7th St, Ste 2e, Terre Haute, IN 47802 Phone: 812-235-7370 Fax: 812-235-7570 | |
Sudha Patel, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 6288 S Frye St, Terre Haute, IN 47802 Phone: 812-894-2130 | |
Dr. Dipen V Shah, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1332 N 7th St, Terre Haute, IN 47807 Phone: 812-478-8888 Fax: 812-478-1114 | |
Dr. Tony K. Nasser, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2723 S 7th Street, Suite A, Terre Haute, IN 47802 Phone: 812-232-8164 Fax: 812-234-6391 |