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Organization
DEKALB MEMORIAL HOSPITAL, INC
Active
Organization
DEKALB MEMORIAL HOSPITAL, INC
Active
Other names
DEKALB HEALTH MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG POLKOW (CEO)
(260) 925-4600
Entity
Organization
Contact information
Practice address
1310 E 7TH ST, SUITE G, AUBURN, IN 46706-2534
(260) 920-2000
(260) 920-2005
Mailing address
PO BOX 623, AUBURN, IN 46706-0623
(260) 927-8105
(260) 927-8026
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
NULL
207Y00000X
Otolaryngology Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100104110I
—
IN
Enumeration date
02/15/2012
Last updated
09/13/2016
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