St Joseph Physicians Southway | |
188 E Southway Blvd Kokomo IN 46902-3650 | |
(765) 453-9000 | |
(765) 457-4443 |
Full Name | St Joseph Physicians Southway |
---|---|
Speciality | Family Medicine |
Location | 188 E Southway Blvd, Kokomo, Indiana |
Authorized Official Name and Position | Andrew Kellar (REGIONAL PRACTICE ADMINISTRATOR) |
Authorized Official Contact | 7654578381 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
St Joseph Physicians Southway 188 E Southway Blvd Kokomo IN 46902-3650 Ph: (765) 453-9000 | St Joseph Physicians Southway 188 E Southway Blvd Kokomo IN 46902-3650 Ph: (765) 453-9000 |
NPI Number | 1477590164 |
---|---|
Provider Enumeration Date | 06/01/2006 |
Last Update Date | 11/16/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477590164 | NPI | - | NPPES |
000000183506 | Other | IN | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Indiana) | Primary |
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