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Organization
DEKALB MEMORIAL HOSPITAL, INC
Active
Organization
DEKALB MEMORIAL HOSPITAL, INC
Active
Other names
DeKalb Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG POLKOW (CEO)
(260) 925-4600
Entity
Organization
Contact information
Practice address
1306 E 7TH ST, SUITE B, AUBURN, IN 46706-2537
(260) 927-1982
(260) 927-8380
Mailing address
PO BOX 623, AUBURN, IN 46706-0623
(260) 927-8105
(260) 333-0664
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100104110N
—
IN
Enumeration date
05/22/2015
Last updated
09/13/2016
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