| West Side Family Medicine Llc | |
|
1909 W Franklin St Evansville IN 47712-5110 | |
| (812) 456-9736 | |
| (812) 456-0140 |
| Full Name | West Side Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1909 W Franklin St, Evansville, Indiana |
| Authorized Official Name and Position | Jeffrey Donald Hunter (OWNER) |
| Authorized Official Contact | 8124569736 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Side Family Medicine Llc 1909 W Franklin St Evansville IN 47712-5110 Ph: (812) 456-9736 | West Side Family Medicine Llc 1909 W Franklin St Evansville IN 47712-5110 Ph: (812) 456-9736 |
| NPI Number | 1033194303 |
|---|---|
| Provider Enumeration Date | 12/09/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033194303 | NPI | - | NPPES |
| 15D0984163 | Other | IN | CLIA NUMBER |
| 200318070A | Medicaid | IN | |
| 163398 | Other | IN | CHILDRENS SPECIAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Indiana) | Primary |
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