| Foundations Family Medicine Pc | |
|
25 W Main St Austin IN 47102-1303 | |
| (812) 794-8100 | |
| (812) 794-8200 |
| Full Name | Foundations Family Medicine Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 25 W Main St, Austin, Indiana |
| Authorized Official Name and Position | William E Cooke (DIRECTOR/OFFICER) |
| Authorized Official Contact | 8127948100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundations Family Medicine Pc 25 W Main St Austin IN 47102-1303 Ph: (812) 794-8100 | Foundations Family Medicine Pc 25 W Main St Austin IN 47102-1303 Ph: (812) 794-8100 |
| NPI Number | 1720097322 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 07/01/2013 |
| Medicare PECOS PAC ID | 8729056262 |
|---|---|
| Medicare Enrollment ID | O20060823000259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720097322 | NPI | - | NPPES |
| 200490500A | Medicaid | IN | |
| DC0744 | Other | IN | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 01056407A (Indiana) | Primary |
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