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General NPI Number Information
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NPI Number | 1366518102
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Entity Type | Organization
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Legal Business Name | WAYNE COUNTY AUDITOR
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 05/11/2016
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Provider Practice Location Address
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Address Line | 203 E MAIN ST
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City | RICHMOND
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State | IN
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Zip | 47374-4208
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Country | US
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Telephone | 765-973-9294
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Fax | 765-973-9233
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Provider Business Mailing Address
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Address Line | 203 E MAIN ST
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City | RICHMOND
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State | IN
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Zip | 47374-4208
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Country | US
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Telephone | 765-973-9294
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Fax | 765-973-9233
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Authorized Official
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Title or Position | MD
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Name | DAVID M KELLER
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Credential |
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Telephone | 765-973-9294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | IN
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