# WINFIELD FAMILY MEDICINE LLC

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

## Provider details

- **NPI number:** 1568413177
- **Authorized official:** DR. BRENT JACOBUS DO, FACOFP (PHYSICIAN/OWNER)
- **Authorized official phone:** (219) 226-1529

## Contact information

- **Practice address:** 9150 E 109TH AVE STE 2A, CROWN POINT, IN 46307-7686
- **Practice address phone:** (219) 226-1529
- **Practice address fax:** (219) 226-2994
- **Mailing address:** 9150 E 109TH AVE, STE 2A, CROWN POINT, IN 46307-7686
- **Mailing address phone:** (219) 226-1529
- **Mailing address fax:** (219) 226-2994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2006
- **Last updated:** 06/12/2015