| Kohles Family Practice Llc | |
|
1815 University Blvd Anderson IN 46012-3164 | |
| (765) 393-1488 | |
| (765) 400-5217 |
| Full Name | Kohles Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1815 University Blvd, Anderson, Indiana |
| Authorized Official Name and Position | Brian K Kohles (PROVIDER) |
| Authorized Official Contact | 7653931488 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kohles Family Practice Llc 1815 University Blvd Anderson IN 46012-3164 Ph: (765) 393-1488 | Kohles Family Practice Llc 1815 University Blvd Anderson IN 46012-3164 Ph: (765) 393-1488 |
| NPI Number | 1619473006 |
|---|---|
| Provider Enumeration Date | 04/04/2018 |
| Last Update Date | 11/26/2018 |
| Medicare PECOS PAC ID | 2264784644 |
|---|---|
| Medicare Enrollment ID | O20181012001212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619473006 | NPI | - | NPPES |
| 300017273 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01040490 (Indiana) | Primary |
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