John L Wheat | |
302 Vine St Clinton IN 47842-2161 | |
(765) 592-3381 | |
(765) 820-1105 |
Full Name | John L Wheat |
---|---|
Speciality | General Practice |
Location | 302 Vine St, Clinton, Indiana |
Authorized Official Name and Position | John Len Wheat (OWNER) |
Authorized Official Contact | 7655923399 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
John L Wheat Po Box 545 Clinton IN 47842-0545 Ph: (765) 592-3381 | John L Wheat 302 Vine St Clinton IN 47842-2161 Ph: (765) 592-3381 |
NPI Number | 1245742808 |
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Provider Enumeration Date | 11/03/2017 |
Last Update Date | 02/06/2024 |
Medicare PECOS PAC ID | 3678830007 |
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Medicare Enrollment ID | O20171120002554 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245742808 | NPI | - | NPPES |
300020656 | Medicaid | IN | |
000001128857 | Other | IN | ANTHEM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 01078016A (Indiana) | Primary |
Provider Name | John L Wheat |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1265876213 PECOS PAC ID: 7719106525 Enrollment ID: I20170809003697 |
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