| Midwest Neurological P.c. | |
|
1312 Professional Blvd Ste 201 Evansville IN 47714-8007 | |
| (812) 476-7523 | |
| (812) 476-6686 |
| Full Name | Midwest Neurological P.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1312 Professional Blvd Ste 201, Evansville, Indiana |
| Authorized Official Name and Position | Kem Frazee (ADMINISTRATOR) |
| Authorized Official Contact | 8124767523 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Neurological P.c. 1312 Professional Blvd Ste 201 Evansville IN 47714-8007 Ph: (812) 476-7523 | Midwest Neurological P.c. 1312 Professional Blvd Ste 201 Evansville IN 47714-8007 Ph: (812) 476-7523 |
| NPI Number | 1851391262 |
|---|---|
| Provider Enumeration Date | 07/28/2005 |
| Last Update Date | 04/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851391262 | NPI | - | NPPES |
| 200187610A | Medicaid | IN | |
| 200271070A | Medicaid | IN | |
| 100329890A | Medicaid | IN | |
| 200271080A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 50003893A (Indiana) | Primary |
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