| La Porte Regional Physician Network | |
|
108 W State St North Judson IN 46366-1320 | |
| (574) 896-5533 | |
| (574) 896-5218 |
| Full Name | La Porte Regional Physician Network |
|---|---|
| Speciality | Family Medicine |
| Location | 108 W State St, North Judson, Indiana |
| Authorized Official Name and Position | Rhonda Volk (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2193262485 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Porte Regional Physician Network Po Box 1690 La Porte IN 46352-1690 Ph: (219) 326-2312 | La Porte Regional Physician Network 108 W State St North Judson IN 46366-1320 Ph: (574) 896-5533 |
| NPI Number | 1942466354 |
|---|---|
| Provider Enumeration Date | 08/05/2008 |
| Last Update Date | 04/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942466354 | NPI | - | NPPES |
| 760420 | Other | IN | MEDICARE |
| 100165070E | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Pulaski Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 414 Lane St, North Judson, IN 46366 Phone: 574-896-4325 | |
La Porte Regional Physician Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 414 Lane St, North Judson, IN 46366 Phone: 574-896-3444 Fax: 574-896-3435 |