Organization
ST. JOSEPH PRIMARY CARE, LLC
Active
Other names
Ascension St. Vincent Specialty Services
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MORRIS (CFO (AMG))
(317) 338-6234
Entity
Organization
Contact information
Practice address
1907 W SYCAMORE ST, KOKOMO, IN 46901-5148
(317) 456-5433
Mailing address
1907 W SYCAMORE ST, KOKOMO, IN 46901-5148
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RX0202X
Medical Oncology Physician
Primary
—
—
2086X0206X
Surgical Oncology Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Enumeration date
09/22/2022
Last updated
10/10/2022
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