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3203 Middle Dr Columbus IN 47203-4427 | |
| (812) 373-2701 | |
| (812) 373-2710 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 3203 Middle Dr, Columbus, Indiana |
| Authorized Official Name and Position | David J Porter (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8123732701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3203 Middle Dr Columbus IN 47203-4427 Ph: (812) 373-2701 | 3203 Middle Dr Columbus IN 47203-4427 Ph: (812) 373-2701 |
| NPI Number | 1407861164 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 01/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407861164 | NPI | - | NPPES |
| 100051320A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 207Q00000X (Indiana) | Primary |
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