St Joseph Primary LLC

NPI #1104866136 in Kokomo, Indiana

Provider Information

NPI Number: 1104866136
Entity Type: Organization
Organization Name: St Joseph Primary LLC
Primary Specialty: Family Medicine
Enumeration Date: Jun 7, 2006
Last Updated: Oct 23, 2007

Practice Location

Address: 3109 W SYCAMORE ST
City: Kokomo
State: Indiana
ZIP Code: 46901-4026
Phone: (765) 457-8381

Authorized Official

Name: ANDREW KELLAR
Title: REGIONAL PRACTICE MANAGER
Phone: (765) 457-8381

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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