| |
1630 O St, Bedford, IN 47421-4117 | |
(812) 279-1745 | |
(812) 279-1794 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 1630 O St, Bedford, Indiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962694372 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 07000953A (Indiana) | Primary |
Mailing Address | Practice Location Address |
---|---|
3923 Chester Blvd, Richmond, IN 47374-1085 Ph: (765) 962-0521 | 1630 O St, Bedford, IN 47421-4117 Ph: (812) 279-1745 |