| Fortville Community Medicine | |
|
717 E Broadway St Fortville IN 46040-1551 | |
| (317) 621-9220 | |
| (317) 621-9222 |
| Full Name | Fortville Community Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 717 E Broadway St, Fortville, Indiana |
| Authorized Official Name and Position | Jeffery Kirkham (CFO) |
| Authorized Official Contact | 3173555822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fortville Community Medicine 717 E Broadway St Fortville IN 46040-1551 Ph: (317) 621-9220 | Fortville Community Medicine 717 E Broadway St Fortville IN 46040-1551 Ph: (317) 621-9220 |
| NPI Number | 1255356549 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 09/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255356549 | NPI | - | NPPES |
| 200406960G | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Workplace Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1776 W State Road 234 Ste 200, Fortville, IN 46040 Phone: 317-482-5000 Fax: 317-482-5005 |