| John D Roscoe MD PC | |
|
2000 Roosevelt Rd Suite 203 Valparaiso IN 46383-2800 | |
| (219) 465-7277 | |
| (219) 464-2957 |
| Full Name | John D Roscoe MD PC |
|---|---|
| Speciality | Family Medicine |
| Location | 2000 Roosevelt Rd, Valparaiso, Indiana |
| Authorized Official Name and Position | John Dominic Roscoe (PRESIDENT) |
| Authorized Official Contact | 2194657277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John D Roscoe MD PC 2000 Roosevelt Rd Suite 203 Valparaiso IN 46383-2800 Ph: (219) 465-7277 | John D Roscoe MD PC 2000 Roosevelt Rd Suite 203 Valparaiso IN 46383-2800 Ph: (219) 465-7277 |
| NPI Number | 1750682233 |
|---|---|
| Provider Enumeration Date | 11/15/2010 |
| Last Update Date | 11/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750682233 | NPI | - | NPPES |
| 100208460A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01030427A (Indiana) | Primary |
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