| Wagoner Medical Center, Llc | |
|
605 East 7th Street Burlington IN 46915-0038 | |
| (765) 566-3351 | |
| (765) 566-2250 |
| Full Name | Wagoner Medical Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 605 East 7th Street, Burlington, Indiana |
| Authorized Official Name and Position | Michelle Wagoner (ADMINISTRATOR) |
| Authorized Official Contact | 7655663351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wagoner Medical Center, Llc Po Box 38 Burlington IN 46915-0038 Ph: (765) 566-3351 | Wagoner Medical Center, Llc 605 East 7th Street Burlington IN 46915-0038 Ph: (765) 566-3351 |
| NPI Number | 1457421497 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 05/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457421497 | NPI | - | NPPES |
| 200062260 | Medicaid | IN |
Trustees Of Purdue University Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 425 E 5th Street, Suite B, Burlington, IN 46915 Phone: 765-564-3016 Fax: 765-564-2608 |