St Joseph Primary LLC

NPI #1982650164 in Kokomo, Indiana

Provider Information

NPI Number: 1982650164
Entity Type: Organization
Organization Name: St Joseph Primary LLC
Primary Specialty: Pediatrics
Enumeration Date: May 26, 2006
Last Updated: Nov 16, 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 ADMINISTRATOR
Phone: (765) 457-8381

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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