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Organization

CAYLOR NICKEL CLINIC, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KIMBERLY S BUMGARNER (DIRECTOR HUMAN RESOURCES)
(260) 919-3302
Entity
Organization

Contact information

Practice address
1 CAYLOR NICKEL SQ, BLUFFTON, IN 46714-2529
(260) 919-3302
(260) 919-3551
Mailing address
1 CAYLOR NICKEL SQ, BLUFFTON, IN 46714-2529
(260) 919-3302
(260) 919-3551

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
261QM1300X
Multi-Specialty Clinic/Center
Primary
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100449040A
IN
05
200383890
IN
Enumeration date
05/17/2006
Last updated
10/21/2011
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