| NPI | 1033110564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J PHILLIPS Director Of Revenue Cycle 765-349-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2011-11-02 |