MEDICARE: ROCKEY FAMILY MEDICINE LLC

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	01028677A	IN

General Provider Information

NPI Number	:	1225238637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKEY FAMILY MEDICINE LLC

Provider Business Mailing Address
First Line	:	3440 S POST RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-8301
Country	:	US
Telephone Number	:	317-862-2429
Fax Number	:	317-862-7461

Provider Business Practice Location Address
First Line	:	3440 S POST RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-8301
Country	:	US
Telephone Number	:	317-862-2429
Fax Number	:	317-862-7461

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DONALD L ROCKEY
Credential	:	M.D.
Telephone Number	:	317-862-2429

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	04/14/2009

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