Mckissick, Robert Alan

Mckissick, Robert Alan is an individual health care provider with primary practice located at 1201 Michigan Ave Suite 270, Logansport IN 46947-1580. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mckissick, Robert Alan can be contacted via phone (574) 722-4921.

Contact Information

Primary practice address
1201 Michigan Ave Suite 270 Logansport IN 46947-1580
Phone: (574) 722-4921
Fax: (574) 739-0520
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01051621A Indiana

Profile Details

NPI number 1699771949
LBN Legal business name Mckissick, Robert Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Aug 3rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699771949 NPPES
Indiana MEDICAID 200247260
Indiana Other 000000091515
Indiana Other 4388483
Indiana Other 080151650

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