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General NPI Number Information
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NPI Number | 1942315759
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Entity Type | Organization
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Legal Business Name | FAMILY PHYSICIANS OF ANDERSON, PC, INC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 141 W 22ND ST SUITE 115
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City | ANDERSON
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State | IN
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Zip | 46016-4304
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Country | US
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Telephone | 765-683-3180
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Fax |
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Provider Business Mailing Address
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Address Line | 141 W 22ND ST SUITE 115
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City | ANDERSON
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State | IN
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Zip | 46016-4304
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Country | US
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Telephone | 765-683-3180
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MARGO JULIANA CARRANCEJIE
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Credential | M.D.
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Telephone | 765-683-3180
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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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