Organization
DEKALB MEMORIAL HOSPITAL, INC
Active
Other names
DEKALB HEALTH MEDICAL GROUP-PUTMAN
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG POLKOW (CEO)
(260) 925-4600
Entity
Organization
Contact information
Practice address
1306 E 7TH ST, D, AUBURN, IN 46706-2536
(260) 927-0599
(260) 927-8756
Mailing address
PO BOX 623, AUBURN, IN 46706-0623
(260) 927-0599
(260) 927-8756
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100104110D
—
IN
05
—
2463909
—
OH
01
—
CC4531
RAILROAD MEDICARE
IN
Enumeration date
11/13/2006
Last updated
09/13/2016
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