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Organization

SHELBY COUNTY FAMILY MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN HORNER (CEO)
(317) 392-3211
Entity
Organization

Contact information

Practice address
30 W RAMPART ST, SUITE 210, SHELBYVILLE, IN 46176-8897
(317) 398-0121
(317) 421-2016
Mailing address
30 WEST RAMPART STREET, SUITE 210, SHELBYVILLE, IN 46176-8897
(317) 398-0121
(317) 421-2016

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100224650A
IN
01
741720
MEDICARE ID
IN
Enumeration date
09/21/2006
Last updated
07/21/2022
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