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1015 Michigan Ave Logansport IN 46947-1526 | |
(574) 732-2468 | |
(574) 739-1414 |
Full Name | |
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Speciality | Clinic/center |
Location | 1015 Michigan Ave, Logansport, Indiana |
Authorized Official Name and Position | Stacy Lynn Williams (DIRECTOR OF BUSINESS OPERATIONS) |
Authorized Official Contact | 5747322468 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1015 Michigan Ave Logansport IN 46947-1526 Ph: (574) 732-2468 | 1015 Michigan Ave Logansport IN 46947-1526 Ph: (574) 732-2468 |
NPI Number | 1184052102 |
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Provider Enumeration Date | 10/30/2013 |
Last Update Date | 10/30/2013 |
Identifier | Type | State | Issuer |
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1184052102 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 71004557A (Indiana) | Primary |
Logansport Family Health Care Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1201 Michigan Avenue, Suite 270, Logansport, IN 46947 Phone: 574-722-4921 Fax: 574-739-0520 | |