Dekalb Memorial Hospital Inc
Organization Active NPI Family Nurse Practitioner · Auburn, IN
NPI 1780117200 · NPPES record last updated Apr 11, 2017
Key facts
- NPI
- 1780117200
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- DEKALB MEMORIAL HOSPITAL INC
- Practice address
- 1061 Smaltz Way
Auburn, IN 46706-9599 - Phone
- (260) 920-2501
- NPI assigned
- Apr 11, 2017
- Organization subpart
- No
Authorized official
- Name
- Craig Polkow
- Title
- Ceo
- Phone
- (260) 920-2501
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
1061 Smaltz Way
Auburn, IN 46706-9599
Mailing address
PO Box 623
Auburn, IN 46706-0623
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100104110 | Medicaid | IN |
Other names
- Dekalb Health Medical Group
Other providers in Auburn, IN
- Dekalb Memorial Hospital
- Dekalb Memorial Hospital Inc
- Dekalb Memorial Hospital Inc
- Dekalb Memorial Hospital Inc
- Dekalb Memorial Hospital Inc
- Dekalb Memorial Hospital, Inc
- Dekalb Memorial Hospital, Inc
- Dekalb Memorial Hospital, Inc
- Dekalb Memorial Hospital, Inc
- Dekalb Memorial Hospital, Inc
All providers in Auburn, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.