| Northeast Regional Family Practice P.c. | |
|
10327 Dawsons Creek Blvd 9 D Wayne IN 46825 | |
| (260) 424-8770 | |
| (260) 469-8774 |
| Full Name | Northeast Regional Family Practice P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 10327 Dawsons Creek Blvd 9 D, Wayne, Indiana |
| Authorized Official Name and Position | Walter David Pepple (PRESIDENT) |
| Authorized Official Contact | 2604228770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Regional Family Practice P.c. 10327 Dawsons Creek Blvd 9 D Wayne IN 46825 Ph: (260) 424-8770 | Northeast Regional Family Practice P.c. 10327 Dawsons Creek Blvd 9 D Wayne IN 46825 Ph: (260) 424-8770 |
| NPI Number | 1154382729 |
|---|---|
| Provider Enumeration Date | 03/31/2006 |
| Last Update Date | 07/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154382729 | NPI | - | NPPES |
| 100103630D | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01023389 (Indiana) | Primary |