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General NPI Number Information
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NPI Number | 1861692246
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Entity Type | Organization
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Legal Business Name | SPICELAND PIKE MEDICAL CENTER PC
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 1685 S SPICELAND RD
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City | NEW CASTLE
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State | IN
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Zip | 47362-8954
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Country | US
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Telephone | 765-529-4090
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Fax |
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Provider Business Mailing Address
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Address Line | 1685 S SPICELAND RD
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City | NEW CASTLE
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State | IN
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Zip | 47362-8954
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEITH DINKLAGE
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Credential |
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Telephone | 765-529-4090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 01041007
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License Number State | IN
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