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2326 18th St Suite 220 Columbus IN 47201-5359 | |
| (812) 378-7474 | |
| (812) 378-7462 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2326 18th St, Columbus, Indiana |
| Authorized Official Name and Position | David Rau (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8123787474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2326 18th St Suite 220 Columbus IN 47201-5359 Ph: (812) 378-7474 | 2326 18th St Suite 220 Columbus IN 47201-5359 Ph: (812) 378-7474 |
| NPI Number | 1952400509 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 06/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952400509 | NPI | - | NPPES |
| CJ7720 | Other | IN | MEDICARE RAILROAD |
| 1952400509 | Other | IN | GROUP NPI |
| 100052820 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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