Mississinewa Medical Center, Dr. Lori Fuqua | |
717 E Main St Gas City IN 46933-1545 | |
(765) 677-4719 | |
(765) 677-4727 |
Full Name | Mississinewa Medical Center, Dr. Lori Fuqua |
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Speciality | Family Medicine |
Location | 717 E Main St, Gas City, Indiana |
Authorized Official Name and Position | Paul L Usher (PRESIDENT/CEO) |
Authorized Official Contact | 7656624776 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mississinewa Medical Center, Dr. Lori Fuqua 1251 W Kem Rd Suite E Marion IN 46952-2555 Ph: (765) 662-4133 | Mississinewa Medical Center, Dr. Lori Fuqua 717 E Main St Gas City IN 46933-1545 Ph: (765) 677-4719 |
NPI Number | 1770761975 |
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Provider Enumeration Date | 02/11/2008 |
Last Update Date | 02/19/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770761975 | NPI | - | NPPES |
100269250 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 01036109A (Indiana) | Primary |
Jon Kevin Blake Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 925 E Main St, Gas City, IN 46933 Phone: 765-674-7889 |