# ST. JOSEPH PRIMARY CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ascension St. Vincent Kokomo Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982736377
- **Authorized official:** BRIAN MORRIS (CFO (AMG))
- **Authorized official phone:** (317) 338-6234

## Contact information

- **Practice address:** 1907 W SYCAMORE ST, KOKOMO, IN 46901-5148
- **Practice address phone:** (765) 456-5433
- **Mailing address:** 3109 W SYCAMORE ST, KOKOMO, IN 46901-4181
- **Mailing address phone:** (765) 457-8381
- **Mailing address fax:** (765) 457-4443

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 742949291 | IN | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 207RI0008X | Hepatology Physician | — | NULL | — |
| 207RI0008X | Hepatology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | — |
| 261QU0200X | Urgent Care Clinic/Center | — | IN | — |

## Other

- **Enumeration date:** 03/12/2007
- **Last updated:** 02/20/2024