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
1310 E 7TH ST, SUITE G, AUBURN, IN 46706-2534
(260) 920-2000
(260) 920-2005
Mailing address
PO BOX 623, AUBURN, IN 46706-0623
(260) 927-8105
(260) 927-8026
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100104110I
—
IN
Enumeration date
02/15/2012
Last updated
09/13/2016
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