West Side Family Medicine Llc
LBN: West Side Family Medicine Llc
West Side Family Medicine Llc is an health care organization with primary practice located at 1909 W Franklin St , Evansville IN 47712-5110. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty.
West Side Family Medicine Llc can be contacted via phone (812) 456-9736, or through Hunter, Jeffrey Donald via phone (812) 456-9736.
Contact Information
Primary practice address
1909 W Franklin St
Evansville IN 47712-5110
Phone: (812) 456-9736
Fax: (812) 456-0140
Website:
Authorized official contact:
Name: Hunter, Jeffrey Donald Doctor of Medicine (MD)
Phone: (812) 456-9736
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | Indiana |
Profile Details
| NPI number | 1033194303 |
|---|---|
| LBN Legal business name | West Side Family Medicine Llc |
| DBA Doing business as | |
| Authorized official | Hunter, Jeffrey Donald Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 9th, 2005 |
| Last updated | Jul 21st, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033194303 | NPPES |
| Indiana | Other | 15D0984163 | CLIA NUMBER |
| Indiana | MEDICAID | 200318070A | CLIA NUMBER |
| Indiana | Other | 163398 | CLIA NUMBER |
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