Dr Jeffrey D Breckenridge, MD | |
925 S Nebraska St, Marion, IN 46953-1874 | |
(765) 664-7492 | |
(765) 664-4356 |
Full Name | Dr Jeffrey D Breckenridge |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 925 S Nebraska St, Marion, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982672069 | NPI | - | NPPES |
000000033416 | Other | MPLAN | |
000000382235 | Other | IN | ANTHEM |
104924162 | Medicaid | MI | |
2619983 | Medicaid | OH | |
200112530 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 01045525A (Indiana) | Secondary |
207Q00000X | Family Medicine | 01045525A (Indiana) | Primary |
Entity Name | Qhg Of Fort Wayne Company Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619918026 PECOS PAC ID: 8628988367 Enrollment ID: O20040429000830 |
Mailing Address | Practice Location Address |
---|---|
Dr Jeffrey D Breckenridge, MD 925 S Nebraska St, Marion, IN 46953-1874 Ph: (765) 664-7492 | Dr Jeffrey D Breckenridge, MD 925 S Nebraska St, Marion, IN 46953-1874 Ph: (765) 664-7492 |
Dr. Philip R Renfroe, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 925 S Nebraska St, Marion, IN 46953 Phone: 765-664-7492 | |
Dr. Mary Ann Mazza, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1700 East 38th St., Marion, IN 46953 Phone: 765-674-3321 Fax: 765-677-3149 | |
Mark A Westfall, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1391 N Baldwin Ave, Marion, IN 46952 Phone: 765-660-7900 | |
Kyle R. Speakman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1391 N Baldwin Avenue, Marion, IN 46952 Phone: 765-660-7900 Fax: 765-671-7751 | |
Mr. Thomas Paul Miller, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1700 E 38th St, Marion, IN 46953 Phone: 765-674-3321 Fax: 765-677-5167 | |
Emil Antonine Balasandiran, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1406 W Bella Dr, Marion, IN 46953 Phone: 765-660-7720 Fax: 765-662-4493 | |
Dale W Economan, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 707 N River Dr, Marion, IN 46952 Phone: 765-573-5999 Fax: 765-662-0312 |