Organization
HOMETOWN HEALTHCARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL E AINSWORTH MD (SOLE PROPRIETOR)
(206) 724-8700
Entity
Organization
Contact information
Practice address
955 HIGH ST, STE 2, DECATUR, IN 46733-2326
(260) 724-8700
(260) 728-3821
Mailing address
955 HIGH ST, STE 2, DECATUR, IN 46733-2326
(260) 724-8700
(260) 728-3821
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01045263A
IN
363L00000X
Nurse Practitioner
71001926A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000105448
ANTHEM
IN
01
—
080154120
RAILROAD MEDICARE
IN
05
—
20274870A
—
IN
01
—
9132
PHP
IN
Enumeration date
02/01/2007
Last updated
11/19/2009
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