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Organization
ST JOSEPH PRIMARY LLC
Active
Organization
ST JOSEPH PRIMARY LLC
Active
Other names
Med One Of St Joseph
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW KELLAR (REGIONAL PRACTICE ADMINISTRATOR)
(765) 457-8381
Entity
Organization
Contact information
Practice address
5111 CLINTON DR, KOKOMO, IN 46902-7136
(765) 453-8800
(765) 457-4443
Mailing address
5111 CLINTON DR, KOKOMO, IN 46902-7136
(765) 453-8800
(765) 457-4443
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
IN
261QU0200X
Urgent Care Clinic/Center
Primary
—
IN
Other
Enumeration date
05/26/2006
Last updated
11/16/2007
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