| Directclinic Llc | |
|
7802 W Jefferson Blvd Fort Wayne IN 46804-4138 | |
| (260) 466-5671 | |
| Not Available |
| Full Name | Directclinic Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 7802 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Sudhakar Krishnan (PRESIDENT & CEO) |
| Authorized Official Contact | 2602121900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Directclinic Llc 6435 W Jefferson Blvd Suite 176 Fort Wayne IN 46804-6203 Ph: (260) 212-1900 | Directclinic Llc 7802 W Jefferson Blvd Fort Wayne IN 46804-4138 Ph: (260) 466-5671 |
| NPI Number | 1710422746 |
|---|---|
| Provider Enumeration Date | 12/29/2016 |
| Last Update Date | 12/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710422746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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