| Montgomery Medical Associates Llc | |
|
542 N 3rd St Montgomery IN 47558-5745 | |
| (812) 486-2842 | |
| Not Available |
| Full Name | Montgomery Medical Associates Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 542 N 3rd St, Montgomery, Indiana |
| Authorized Official Name and Position | Mary Joan Holsopple (PRACTICE MANAGER) |
| Authorized Official Contact | 8124862842 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montgomery Medical Associates Llc Po Box 102 Montgomery IN 47558-0102 Ph: (812) 486-2842 | Montgomery Medical Associates Llc 542 N 3rd St Montgomery IN 47558-5745 Ph: (812) 486-2842 |
| NPI Number | 1023205754 |
|---|---|
| Provider Enumeration Date | 09/26/2007 |
| Last Update Date | 05/06/2021 |
| Medicare PECOS PAC ID | 3072693126 |
|---|---|
| Medicare Enrollment ID | O20080214000123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023205754 | NPI | - | NPPES |
| 200864610A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Merle R Holsopple |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538137294 PECOS PAC ID: 8921069055 Enrollment ID: I20041025001129 |
| Provider Name | Kira Dent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083133615 PECOS PAC ID: 5193081438 Enrollment ID: I20171102001164 |
| Provider Name | Lori D Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538710090 PECOS PAC ID: 6204168131 Enrollment ID: I20191026000122 |
| Provider Name | Taryn M Harrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346858479 PECOS PAC ID: 9739509852 Enrollment ID: I20201012001080 |
Montgomery Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 427 N 1st St, Montgomery, IN 47758 Phone: 812-486-2842 Fax: 812-486-2784 | |
Prairie Creek Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Rr 1 Box 216, Montgomery, IN 47558 Phone: 812-687-7263 Fax: 812-687-7264 | |
Country Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5066 N 900 E, Montgomery, IN 47558 Phone: 812-486-3396 Fax: 812-486-3354 |