Organization
HORIZON FAMILY MEDICINE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUDE J MOMODU M.D (CEO)
(317) 493-1053
Entity
Organization
Contact information
Practice address
3737 N MERIDIAN ST STE 501, INDIANAPOLIS, IN 46208
(317) 493-1053
(317) 426-2208
Mailing address
3737 N MERIDIAN ST STE 501, INDIANAPOLIS, IN 46208-4383
(317) 493-1053
(317) 426-2208
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
01057399A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295089621
NPI
IN
01
—
15D2052802
CLIA (CMS)
IN
Enumeration date
11/07/2012
Last updated
06/03/2020
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