Charlestown Primary Care Llc in Charlestown - Nurse Practitioner
Charlestown Primary Care Llc - NPI 1114108164
Charlestown Primary Care Llc is a Nurse Practitioner in Charlestown, Indiana. Charlestown Primary Care Llc practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Charlestown Primary Care Llc is 1114108164. The last update date is 2019-04-18.
Charlestown Primary Care Llc's current location address is 3901 County Road 160, Charlestown, Indiana. You can contact this provider via phone number 8124066897 and fax number 8122563577. The mailing address for Charlestown Primary Care Llc is 3901 County Road 160, Charlestown, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Charlestown Primary Care Llc |
|---|---|
| Address | 3901 County Road 160, Charlestown, Indiana |
| Phone Number | 8124066897 |
| Fax Number | 8122563577 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEMBER |
|---|---|
| Authorized Official Name | Hoke E Willam |
| Credentials | MD |
| Telephone Number | 8122561106 |
NPI Number Detail
| NPI Number | 1114108164 |
|---|---|
| Provider Enumeration Date | 2007-11-19 |
| Last Updated Date | 2019-04-18 |
Provider Mailing Address Detail
| Address | 3901 County Road 160 |
|---|---|
| City | Charlestown |
| State | Indiana (IN) |
| Post Code | 471119181 |
| Phone Number | 8124066897 |
| Fax Number | 8122563577 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | 71003560A |
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Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 549269 | IN | ANTHEM GROUP NUMBER | |
| 20089454A | IN | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Charlestown Primary Care Llc by the Centers for Medicare & Medicaid Services?
The Charlestown Primary Care Llc has been assigned the NPI (National Provider Identifier) 1114108164 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete address where Charlestown Primary Care Llc is physically located?
The Charlestown Primary Care Llc is situated at the following address: 3901 County Road 160, Charlestown, IN 471119181.
What is Charlestown Primary Care Llc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Charlestown Primary Care Llc's specialized field of practice is Nurse Practitioner, and the corresponding taxonomy code that categorizes this area of specialization is 363L00000X.
When did Charlestown Primary Care Llc receive its 1114108164 assignment?
The Charlestown Primary Care Llc was assigned its 1114108164 on 2007-11-19, which is the date when this unique identifier was issued to the organization.
When was the information pertaining to Charlestown Primary Care Llc most recently updated or revised?
The details related to Charlestown Primary Care Llc, including its address, specialty, and other relevant information, were last updated or revised on 2019-04-18.