| Jack Feliciano Md, Inc | |
|
2401 W University Ave Muncie IN 47303-3428 | |
| (765) 751-5253 | |
| (765) 282-8796 |
| Full Name | Jack Feliciano Md, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2401 W University Ave, Muncie, Indiana |
| Authorized Official Name and Position | Elpidio M Feliciano (OWNER/PHYSICIAN) |
| Authorized Official Contact | 3173854445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack Feliciano Md, Inc 16531 Stonewolf Blvd Noblesville IN 46060-1290 Ph: (765) 284-0493 | Jack Feliciano Md, Inc 2401 W University Ave Muncie IN 47303-3428 Ph: (765) 751-5253 |
| NPI Number | 1942615497 |
|---|---|
| Provider Enumeration Date | 06/24/2014 |
| Last Update Date | 08/26/2014 |
| Medicare PECOS PAC ID | 8527382514 |
|---|---|
| Medicare Enrollment ID | O20150126000324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942615497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01056999 (Indiana) | Primary |
| Provider Name | Elpidio M Feliciano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659358745 PECOS PAC ID: 0244286292 Enrollment ID: I20050323000835 |
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