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Organization
HANCOCK HEALTH GATEWAY SERVICES, INC.
Active
Organization
HANCOCK HEALTH GATEWAY SERVICES, INC.
Active
Other names
Gateway Immediate Care
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN LONG (CEO)
(317) 468-4412
Entity
Organization
Contact information
Practice address
6189 JOHN L. MODGLIN DR, SUITE 101, GREENFIELD, IN 46140-9364
(317) 866-7300
Mailing address
6189 W JOHN L. MODGLIN DR, SUITE 101, GREENFIELD, IN 46140-9364
(317) 866-7300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/14/2018
Last updated
06/25/2019
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