Organization
ESGUERRA MEDICAL PRACTICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL R ESGUERRA MD (OWNER)
(812) 847-8711
Entity
Organization
Contact information
Practice address
2125 E STATE HIGHWAY 54, LINTON, IN 47441-9407
(812) 847-8711
(812) 847-8793
Mailing address
2125 E STATE HIGHWAY 54, LINTON, IN 47441-9407
(812) 847-8711
(812) 847-8793
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01039089
IN
207QA0000X
Adolescent Medicine (Family Medicine) Physician
01039089
IN
207QA0401X
Addiction Medicine (Family Medicine) Physician
01039089
IN
207QA0505X
Adult Medicine Physician
01039089
IN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
01039089
IN
207QS0010X
Sports Medicine (Family Medicine) Physician
01039089
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000089459
BLUE CROSS/BLUE SHIELD
IN
05
—
100125020A
—
IN
Enumeration date
02/20/2008
Last updated
12/29/2020
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