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Organization
ST JOSEPH PRIMARY LLC
Active
Organization
ST JOSEPH PRIMARY LLC
Active
Other names
Sycamore Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW KELLAR (REGIONAL PRACTICE MANAGER)
(765) 457-8381
Entity
Organization
Contact information
Practice address
3109 W SYCAMORE ST, KOKOMO, IN 46901-4026
(765) 457-8381
(765) 457-4443
Mailing address
3109 W SYCAMORE ST, KOKOMO, IN 46901-4026
(765) 457-8381
(765) 457-4443
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IN
Other
Enumeration date
06/07/2006
Last updated
10/23/2007
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