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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