| Hometown Family Medicine Llc | |
|
103 W Main St Lizton IN 46149-9219 | |
| (317) 520-2926 | |
| (585) 312-6697 |
| Full Name | Hometown Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 103 W Main St, Lizton, Indiana |
| Authorized Official Name and Position | Jennifer L Behrens (OWNER) |
| Authorized Official Contact | 3175202926 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hometown Family Medicine Llc Po Box 239 Lizton IN 46149-0239 Ph: (317) 520-2926 | Hometown Family Medicine Llc 103 W Main St Lizton IN 46149-9219 Ph: (317) 520-2926 |
| NPI Number | 1679157390 |
|---|---|
| Provider Enumeration Date | 05/09/2021 |
| Last Update Date | 05/09/2021 |
| Medicare PECOS PAC ID | 3375945124 |
|---|---|
| Medicare Enrollment ID | O20210715002699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679157390 | NPI | - | NPPES |
| 300049386 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer L Behrens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023402583 PECOS PAC ID: 0941513758 Enrollment ID: I20180830001397 |
Iu Health Workplace Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Church St, Lizton, IN 46149 Phone: 317-994-4110 Fax: 317-994-6299 | |
Lizton Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1045 Wyatt Way, Lizton, IN 46149 Phone: 317-994-6600 Fax: 317-994-6605 |