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Organization

BEACON PRIMARY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PETER DONALD FARR (OWNER)
(317) 559-7970
Entity
Organization

Contact information

Practice address
10967 ALLISONVILLE RD STE 110, FISHERS, IN 46038-2634
(317) 599-5970
Mailing address
10967 ALLISONVILLE RD STE 110, FISHERS, IN 46038-2634
(317) 559-5970
(317) 559-7971

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
IN3378
MEDICARE PTAN
IN
Enumeration date
10/19/2016
Last updated
01/07/2020
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