Individual
DR. GARY ALLEN BABCOKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
650 DICKINSON RD, SUITE A, CHESTERTON, IN 46304-3387
(219) 926-2133
(219) 926-8765
Mailing address
26700 BROOKPARK ROAD EXT, SUITE 1, NORTH OLMSTED, OH 44070-3124
(800) 611-6912
(440) 716-1605
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01019380A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000090560
ANTHEM
IN
Enumeration date
03/29/2006
Last updated
07/08/2007
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