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NPI Code Detail

MEDICARE: JAMES ALAN HANDTKE DO

MEDICARE: JAMES ALAN HANDTKE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician02007362AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033748710
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES ALAN HANDTKE DO
Provider Business Mailing Address
First Line : 3245 HEALTH DR STE 100
Second Line :
City : GRANGER
State : IN
Zip : 46530-1380
Country : US
Telephone Number : 547-647-1840
Fax Number :
Provider Business Practice Location Address
First Line : 206 W WARREN ST
Second Line :
City : MIDDLEBURY
State : IN
Zip : 46540-9410
Country : US
Telephone Number : 574-825-2146
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2020
Last Update Date : 08/30/2023

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