Organization
LAWRENCE R CURRY
Active
Other names
Mckinley Medical Clinic, McKinley Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSEMARIE SCOTT (ADMINISTRATOR)
(260) 350-2180
Entity
Organization
Contact information
Practice address
524 E MCKINLEY AVE, MISHAWAKA, IN 46545-6285
(574) 256-2556
(574) 258-4278
Mailing address
524 E MCKINLEY AVE, MISHAWAKA, IN 46545-6285
(574) 256-2556
(574) 258-4278
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02000570A
IN
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000101533
ANTHEM BCBS
IN
05
—
100092660
—
IN
01
—
735210
MEDICARE PTAN
IN
Enumeration date
10/04/2006
Last updated
09/28/2020
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