MEDICARE: PREFERRED PHYSICIANS PC

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1265594253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED PHYSICIANS PC

Provider Business Mailing Address
First Line	:	2005 N WALNUT ST
Second Line	:
City	:	HARTFORD CITY
State	:	IN
Zip	:	47348-1365
Country	:	US
Telephone Number	:	765-348-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 N WALNUT ST
Second Line	:
City	:	HARTFORD CITY
State	:	IN
Zip	:	47348-1365
Country	:	US
Telephone Number	:	765-348-1100
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	STEPHEN R MYRON
Credential	:	MD
Telephone Number	:	260-726-9027

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	04/02/2008

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