Organization
HANCOCK HEALTH GATEWAY SERVICES, INC.
Active
Other names
Gateway Immediate Care
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN LONG (CEO)
(317) 468-4412
Entity
Organization
Contact information
Practice address
6189 JOHN L. MODGLIN DR, SUITE 101, GREENFIELD, IN 46140-9364
(317) 866-7300
Mailing address
6189 W JOHN L. MODGLIN DR, SUITE 101, GREENFIELD, IN 46140-9364
(317) 866-7300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/14/2018
Last updated
06/25/2019
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