Healthcare Provider Details

I. General information

NPI: 1720002298
Provider Name (Legal Business Name): DAVID F FELKINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 03/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10122 E 10TH ST SUITE 210
INDIANAPOLIS IN
46229-2664
US

IV. Provider business mailing address

6626 E. 75TH STREET SUITE 500
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 317-355-2230
  • Fax: 317-355-2305
Mailing address:
  • Phone: 317-355-2184
  • Fax: 317-355-7329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01026231A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: