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General NPI Number Information
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NPI Number | 1205662301
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Entity Type | Organization
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Legal Business Name | INDYCARE CARELINK PLLC
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 106 BROADWAY ST STE A
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City | ELSBERRY
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State | MO
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Zip | 63343-1345
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Country | US
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Telephone | 573-200-6593
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Fax |
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Provider Business Mailing Address
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Address Line | 120 MOSAIC BLVD STE 200-4
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City | PITTSBORO
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State | NC
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Zip | 27312-4966
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Country | US
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Telephone | 919-259-1300
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | FRANKLIN ROYE
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Credential |
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Telephone | 919-259-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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