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8141 Kennedy Avenue Highland IN 46322-1128 | |
| (219) 838-5040 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 8141 Kennedy Avenue, Highland, Indiana |
| Authorized Official Name and Position | Leobardo Correa (CEO) |
| Authorized Official Contact | 2193921700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9660 Wicker Ave St John IN 46373-9487 Ph: (219) 226-2203 | 8141 Kennedy Avenue Highland IN 46322-1128 Ph: (219) 838-5040 |
| NPI Number | 1083853139 |
|---|---|
| Provider Enumeration Date | 02/12/2009 |
| Last Update Date | 07/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083853139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01030648 (Indiana) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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