| Mckinley Medical Clinic | |
|
524 E Mckinley Ave Mishawaka IN 46545-6285 | |
| (574) 256-2556 | |
| (574) 258-4278 |
| Full Name | Mckinley Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 524 E Mckinley Ave, Mishawaka, Indiana |
| Authorized Official Name and Position | Rosemarie Scott (ADMINISTRATOR) |
| Authorized Official Contact | 2603502180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mckinley Medical Clinic 524 E Mckinley Ave Mishawaka IN 46545-6285 Ph: (574) 256-2556 | Mckinley Medical Clinic 524 E Mckinley Ave Mishawaka IN 46545-6285 Ph: (574) 256-2556 |
| NPI Number | 1811082670 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 09/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811082670 | NPI | - | NPPES |
| 735210 | Other | IN | MEDICARE PTAN |
| 100092660 | Medicaid | IN | |
| 000000101533 | Other | IN | ANTHEM BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 02000570A (Indiana) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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