| Jackson Park Physicians, Pc | |
|
1124 Medical Place Seymour IN 47274 | |
| (812) 522-1613 | |
| (812) 522-6694 |
| Full Name | Jackson Park Physicians, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1124 Medical Place, Seymour, Indiana |
| Authorized Official Name and Position | Kelley M Gillaspy (PRACTICE MANAGER) |
| Authorized Official Contact | 8125221613 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Park Physicians, Pc 1124 Medical Place Seymour IN 47274 Ph: (812) 522-1613 | Jackson Park Physicians, Pc 1124 Medical Place Seymour IN 47274 Ph: (812) 522-1613 |
| NPI Number | 1346388576 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 06/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346388576 | NPI | - | NPPES |
| 100141330 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 50000714A (Indiana) | Primary |
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