# CHARLESTOWN PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114108164
- **Authorized official:** DR. WILLAM E HOKE MD (MEMBER)
- **Authorized official phone:** (812) 256-1106

## Contact information

- **Practice address:** 3901 COUNTY ROAD 160, CHARLESTOWN, IN 47111-9181
- **Practice address phone:** (812) 406-6897
- **Practice address fax:** (812) 256-3577
- **Mailing address:** 3901 COUNTY ROAD 160, CHARLESTOWN, IN 47111-9181
- **Mailing address phone:** (812) 406-6897
- **Mailing address fax:** (812) 256-3577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01061465A | IN | Yes |
| 363L00000X | Nurse Practitioner | 71003560A | IN | — |
| 363LF0000X | Family Nurse Practitioner | 71002399A | IN | — |

## Other

- **Enumeration date:** 11/19/2007
- **Last updated:** 04/18/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000549269 | ANTHEM GROUP NUMBER | IN |
| 05 | — | 20089454A | — | IN |