| Eastern Indiana Neurology, P.c. | |
|
1508 W White River Blvd Muncie IN 47303-4949 | |
| (765) 288-6828 | |
| (765) 741-3979 |
| Full Name | Eastern Indiana Neurology, P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1508 W White River Blvd, Muncie, Indiana |
| Authorized Official Name and Position | John D Wulff (MD) |
| Authorized Official Contact | 7652886828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Indiana Neurology, P.c. 1508 W White River Blvd Muncie IN 47303-4949 Ph: (765) 288-6828 | Eastern Indiana Neurology, P.c. 1508 W White River Blvd Muncie IN 47303-4949 Ph: (765) 288-6828 |
| NPI Number | 1861527384 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8820263247 |
|---|---|
| Medicare Enrollment ID | O20111214000438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861527384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 01028724 (Indiana) | Primary |
| 2084N0400X | Psychiatry & Neurology - Neurology | 01041561 (Indiana) | Secondary |
| Provider Name | Hal S Dickson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992780894 PECOS PAC ID: 2163619552 Enrollment ID: I20101210000781 |
| Provider Name | John D Wulff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477530913 PECOS PAC ID: 7719152131 Enrollment ID: I20111214000464 |
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