# STARKE PHYSICIAN PRACTICES LLC

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

## Provider details

- **NPI number:** 1790805125
- **Authorized official:** MR. THOMAS WEISS (PRESIDENT)
- **Authorized official phone:** (615) 372-8500

## Contact information

- **Practice address:** 104 E CULVER RD, SUITE 103, KNOX, IN 46534-2216
- **Practice address phone:** (574) 772-2114
- **Practice address fax:** (574) 772-2802
- **Mailing address:** PO BOX 428, KNOX, IN 46534-0428
- **Mailing address phone:** (574) 772-2114
- **Mailing address fax:** (574) 772-2802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 03/30/2007
- **Last updated:** 07/07/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000518052 | ANTHEM BLUE CROSS | IN |
| 05 | — | 200860110A | — | IN |