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8988 E Us Highway 20 New Carlisle IN 46552-9038 | |
(574) 654-7779 | |
(574) 654-7780 |
Full Name | |
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Speciality | Family Medicine |
Location | 8988 E Us Highway 20, New Carlisle, Indiana |
Authorized Official Name and Position | Rhonda Volk (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2193262485 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1690 La Porte IN 46352-1690 Ph: (219) 326-2312 | 8988 E Us Highway 20 New Carlisle IN 46552-9038 Ph: (574) 654-7779 |
NPI Number | 1336250737 |
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Provider Enumeration Date | 08/31/2006 |
Last Update Date | 06/06/2008 |
Identifier | Type | State | Issuer |
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1336250737 | NPI | - | NPPES |
100165070W | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |