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EMILY A BACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
408 E SOUTHWAY BLVD, KOKOMO, IN 46902-3814
(765) 865-3300
(765) 865-3306
Mailing address
6626 E. 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01045272
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200196050
IN
01
P01270963
RR MEDICARE
IN
Enumeration date
01/27/2006
Last updated
11/27/2023
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