Organization
WEST SIDE FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY DONALD HUNTER M.D. (OWNER)
(812) 456-9736
Entity
Organization
Contact information
Practice address
1909 W FRANKLIN ST, EVANSVILLE, IN 47712-5110
(812) 456-9736
(812) 456-0140
Mailing address
1909 W FRANKLIN ST, EVANSVILLE, IN 47712-5110
(812) 456-9736
(812) 456-0140
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15D0984163
CLIA NUMBER
IN
01
—
163398
CHILDRENS SPECIAL HEALTH
IN
05
—
200318070A
—
IN
Enumeration date
12/09/2005
Last updated
07/21/2022
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