| Indian Lake Medical Center | |
|
322 E Main St Russells Point OH 43348-9601 | |
| (937) 842-2318 | |
| (937) 842-2414 |
| Full Name | Indian Lake Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 322 E Main St, Russells Point, Ohio |
| Authorized Official Name and Position | Jeffrey Utz (DIRECTOR OF LMP) |
| Authorized Official Contact | 4199984668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian Lake Medical Center 1001 Bellefontaine Ave Lima OH 45804-2800 Ph: (419) 998-4575 | Indian Lake Medical Center 322 E Main St Russells Point OH 43348-9601 Ph: (937) 842-2318 |
| NPI Number | 1558788646 |
|---|---|
| Provider Enumeration Date | 03/26/2014 |
| Last Update Date | 04/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558788646 | NPI | - | NPPES |
| 1457474900 | Other | OH | GROUP NPI |
| 2223703 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Costin Family Practice, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 303 East Main Street, Russells Point, OH 43348 Phone: 937-843-2453 | |
Community Health & Wellness Partners Of Logan County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8200 State Route 366 Ste 1, Russells Point, OH 43348 Phone: 937-599-1411 Fax: 937-599-4128 | |
Lakeview Medical, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8200 State Route 366, Russells Point, OH 43348 Phone: 937-843-5000 Fax: 937-843-2801 | |
Indian Lake Community Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8200 State Route 366, Suite No. 1, Russells Point, OH 43348 Phone: 937-599-1411 Fax: 937-599-4128 |