| St Joseph Physicians Southway | |
|
188 E Southway Blvd Kokomo IN 46902-3650 | |
| (765) 453-9000 | |
| (765) 457-4443 |
| Full Name | St Joseph Physicians Southway |
|---|---|
| Speciality | Family Medicine |
| Location | 188 E Southway Blvd, Kokomo, Indiana |
| Authorized Official Name and Position | Andrew Kellar (REGIONAL PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 7654578381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Joseph Physicians Southway 188 E Southway Blvd Kokomo IN 46902-3650 Ph: (765) 453-9000 | St Joseph Physicians Southway 188 E Southway Blvd Kokomo IN 46902-3650 Ph: (765) 453-9000 |
| NPI Number | 1477590164 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 11/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477590164 | NPI | - | NPPES |
| 000000183506 | Other | IN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Indiana) | Primary |
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