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157 W 8th St Fairmount IN 46928-1012 | |
(765) 660-7880 | |
(765) 382-4490 |
Full Name | |
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Speciality | Internal Medicine |
Location | 157 W 8th St, Fairmount, Indiana |
Authorized Official Name and Position | Stephanie Hilton-siebert (PRESIDENT/CEO) |
Authorized Official Contact | 7656607005 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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330 N Wabash Ste G20 Marion IN 46952-2555 Ph: (765) 660-7880 | 157 W 8th St Fairmount IN 46928-1012 Ph: (765) 660-7880 |
NPI Number | 1619020575 |
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Provider Enumeration Date | 01/22/2007 |
Last Update Date | 06/16/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619020575 | NPI | - | NPPES |
100269250 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |