Organization
KNOX FAMILY PRACTICE
Active
Other names
Knox Family Practice RHC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA R FRITZ (OFFICE MANAGER)
(574) 772-2188
Entity
Organization
Contact information
Practice address
1520 S HEATON ST, KNOX, IN 46534-2393
(574) 772-2188
(574) 772-2190
Mailing address
1520 S HEATON ST, KNOX, IN 46534-2393
(574) 772-2188
(574) 772-2190
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
50000720A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083056
ANTHEM PIN
IN
01
—
01024309A
WALTER FRITZ, M.D. LICENS
IN
01
—
50000720A
CORPORATION LICENSE
IN
Enumeration date
03/14/2007
Last updated
08/22/2020
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