Healthcare Provider Details

I. General information

NPI: 1548490972
Provider Name (Legal Business Name): ABIGAIL ELIZABETH KAERCHER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABIGAIL ELIZABETH GINTHER PA-C

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 W BOULEVARD
KOKOMO IN
46902-6079
US

IV. Provider business mailing address

6626 E 75TH ST STE 500
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 765-776-3900
  • Fax: 765-453-8050
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number58030906
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA057378
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number02007538A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: