Basic Information
| Provider Information | |||||||||
| NPI: | 1265558829 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY PRACTICE ASSOCIATES, LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2003 STULTS RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HUNTINGTON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 467501291 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2603565424 | ||||||||
| FaxNumber: | 2603582090 | ||||||||
| Practice Location | |||||||||
| Address1: | 2003 STULTS RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HUNTINGTON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 467501291 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2603565424 | ||||||||
| FaxNumber: | 2603582090 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2007 | ||||||||
| LastUpdateDate: | 09/07/2007 | ||||||||
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| AuthorizedOfficialLastName: | WEBB | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 2603565424 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.