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Organization
J S MIDMORE MD PC
Active
Organization
J S MIDMORE MD PC
Active
Other names
John Steven Midmore MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN STEVEN MIDMORE MD (PHYSICIAN OWNER)
(570) 988-0925
Entity
Organization
Contact information
Practice address
3156 WILLOWCREEK RD, PORTAGE, IN 46368-4424
(219) 547-5999
Mailing address
PO BOX 1873, VALPARAISO, IN 46384-1873
(219) 476-0352
(219) 531-0859
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
0104887A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100340370B
—
IN
01
—
DU8259
RR MCR
IN
Enumeration date
05/04/2007
Last updated
10/10/2014
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