Kevin R Ericson in Mishawaka - Family Medicine
Kevin R Ericson - NPI 1265458749
Kevin R Ericson is a Family Medicine in Mishawaka, Indiana. Kevin R Ericson practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Kevin R Ericson is 1265458749. The last update date is 2012-07-13.
Kevin R Ericson's current location address is 611 E Douglas Rd, Mishawaka, Indiana. You can contact this provider via phone number 5743356500 and fax number 5743350772. The mailing address for Kevin R Ericson is 611 E Douglas Rd, Mishawaka, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin R Ericson |
|---|---|
| Address | 611 E Douglas Rd, Mishawaka, Indiana |
| Phone Number | 5743356500 |
| Fax Number | 5743350772 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1265458749 |
|---|---|
| Provider Enumeration Date | 2006-07-15 |
| Last Updated Date | 2012-07-13 |
Provider Mailing Address Detail
| Address | 611 E Douglas Rd |
|---|---|
| City | Mishawaka |
| State | Indiana (IN) |
| Post Code | 465451464 |
| Phone Number | 5743356500 |
| Fax Number | 5743350772 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 1046492 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200142060A | IN | MEDICAID |
Post Comment/ Review Below
What is the unique identifier code issued to Kevin R Ericson by the Centers for Medicare & Medicaid Services?
The Kevin R Ericson has been assigned the NPI (National Provider Identifier) 1265458749. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Kevin R Ericson's physical address?
The Kevin R Ericson is physically located at 611 E Douglas Rd, in the city of Mishawaka, IN, with the postal code 465451464.
What is Kevin R Ericson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Kevin R Ericson is Family Medicine, and the taxonomy classification code that categorizes this area of expertise is 207Q00000X.
When did the Kevin R Ericson receive its 1265458749?
The Kevin R Ericson was issued its 1265458749 on 2006-07-15, which is the date when the organization was assigned this unique identifier.
When was the information pertaining to Kevin R Ericson most recently updated or revised?
The details related to Kevin R Ericson, including its address, specialty, and other relevant information, were last updated or revised on 2012-07-13.