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Organization
STARKE PHYSICIAN PRACTICES LLC
Active
Organization
STARKE PHYSICIAN PRACTICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS WEISS (PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
104 E CULVER RD, SUITE 103, KNOX, IN 46534-2216
(574) 772-2114
(574) 772-2802
Mailing address
PO BOX 428, KNOX, IN 46534-0428
(574) 772-2114
(574) 772-2802
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000518052
ANTHEM BLUE CROSS
IN
05
—
200860110A
—
IN
Enumeration date
03/30/2007
Last updated
07/07/2008
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