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1809 S Main St Upland IN 46989-9242 | |
(765) 992-6200 | |
(765) 998-6204 |
Full Name | |
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Speciality | Family Medicine |
Location | 1809 S Main St, Upland, Indiana |
Authorized Official Name and Position | Janet L Vangets (DIRECTOR/OFFICER) |
Authorized Official Contact | 7657515404 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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221 N Celia Ave Attn: Debera Barker Muncie IN 47303-4609 Ph: (765) 282-8905 | 1809 S Main St Upland IN 46989-9242 Ph: (765) 992-6200 |
NPI Number | 1699094870 |
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Provider Enumeration Date | 05/27/2010 |
Last Update Date | 11/01/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699094870 | NPI | - | NPPES |
200991210A | Medicaid | IN | |
DQ6230 | Other | IN | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Central Indiana Orthopedics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1809 S Main St, Upland, IN 46989 Phone: 765-284-7738 Fax: 765-213-3713 | |