| Wolcott Family Medicine, Llc | |
|
128 W Market Street Wolcott IN 47995 | |
| (219) 279-2264 | |
| (219) 279-2279 |
| Full Name | Wolcott Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 128 W Market Street, Wolcott, Indiana |
| Authorized Official Name and Position | James K Shields (OWNER/PHYSICIAN) |
| Authorized Official Contact | 2192792264 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wolcott Family Medicine, Llc Po Box 4699 Lafayette IN 47903-4699 Ph: (219) 279-2264 | Wolcott Family Medicine, Llc 128 W Market Street Wolcott IN 47995 Ph: (219) 279-2264 |
| NPI Number | 1497946818 |
|---|---|
| Provider Enumeration Date | 08/09/2007 |
| Last Update Date | 09/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497946818 | NPI | - | NPPES |
| 100196860 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01027166A (Indiana) | Primary |
Family Health Clinic Of Wolcott Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 128 W Market St, Wolcott, IN 47995 Phone: 219-747-2067 Fax: 219-747-2068 |