MEDICARE: ROHRER FAMILY CLINIC,INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	02000342A	IN

General Provider Information

NPI Number	:	1053591370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROHRER FAMILY CLINIC,INC

Provider Business Mailing Address
First Line	:	1027 WASHINGTON AVE
Second Line	:	SUITE B
City	:	VINCENNES
State	:	IN
Zip	:	47591-2240
Country	:	US
Telephone Number	:	812-882-3816
Fax Number	:	812-886-5914

Provider Business Practice Location Address
First Line	:	1027 WASHINGTON AVE
Second Line	:	SUITE B
City	:	VINCENNES
State	:	IN
Zip	:	47591-2240
Country	:	US
Telephone Number	:	812-882-3816
Fax Number	:	812-886-5914

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	LISA A PIGG
Credential	:	MA
Telephone Number	:	812-882-3816

Provider Enumeration Date	:	11/05/2007
Last Update Date	:	11/30/2007

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