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General NPI Number Information
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NPI Number | 1992506588
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Entity Type | Organization
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Legal Business Name | GERIATRIC PRIMARY CARE OF INDIANA LLC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 5354 W 62ND ST APT 176C
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-6436
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Country | US
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Telephone | 850-377-0925
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Fax |
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Provider Business Mailing Address
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Address Line | 12120 STATE LINE RD # 296
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City | LEAWOOD
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State | KS
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Zip | 66209-1254
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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 | CEO
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Name | MR. MARK BATTIST
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Credential |
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Telephone | 850-377-0925
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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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