Organization
COUNTY SEAT EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(954) 838-2371
Entity
Organization
Contact information
Practice address
1300 S JACKSON ST, FRANKFORT, IN 46041-3313
(765) 656-3000
(765) 654-2803
Mailing address
PO BOX 13970, PHILADELPHIA, PA 19101-3970
(954) 838-2371
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000386125
BLUE SHIELD
IN
05
—
200817680A
—
IN
Enumeration date
06/03/2006
Last updated
08/20/2019
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