| Loogootee Family Medicine | |
|
105 Cooper St Loogootee IN 47553 | |
| (812) 295-2812 | |
| (812) 295-3726 |
| Full Name | Loogootee Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 105 Cooper St, Loogootee, Indiana |
| Authorized Official Name and Position | Edward Kyle Bennett (PRESIDENT, CEO) |
| Authorized Official Contact | 8129960507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Loogootee Family Medicine Po Box 1028 Jasper IN 47547-1028 Ph: (812) 996-8478 | Loogootee Family Medicine 105 Cooper St Loogootee IN 47553 Ph: (812) 295-2812 |
| NPI Number | 1740360700 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 07/17/2018 |
| Medicare PECOS PAC ID | 4587578042 |
|---|---|
| Medicare Enrollment ID | O20090910000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740360700 | NPI | - | NPPES |
| 200048850E | Medicaid | IN | |
| CB3118 | Other | IN | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
Good Samaritan Family Health Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Brooks Ave, Loogootee, IN 47553 Phone: 812-494-9514 Fax: 812-494-9515 | |
Dr Rick D Bauer Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 W Main St, Loogootee, IN 47553 Phone: 812-295-3163 | |
Good Samaritan Family Health Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 S John F Kennedy Ave, Loogootee, IN 47553 Phone: 812-295-3090 Fax: 812-295-4328 | |
Daviess-martin Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12546 E Us Highway 50, Loogootee, IN 47553 Phone: 812-295-5095 Fax: 812-295-9403 |