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6920 S East St Suite B Indianapolis IN 46227-2215 | |
| (317) 497-6880 | |
| (317) 497-6881 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 6920 S East St, Indianapolis, Indiana |
| Authorized Official Name and Position | Jeffery Kirkham (CFO) |
| Authorized Official Contact | 3173555822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6920 S East St Suite B Indianapolis IN 46227-2215 Ph: (317) 497-6880 | 6920 S East St Suite B Indianapolis IN 46227-2215 Ph: (317) 497-6880 |
| NPI Number | 1205880325 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 11/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205880325 | NPI | - | NPPES |
| 200326750O | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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