Basic Information
| Provider Information | |||||||||
| NPI: | 1477852499 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTHEACCESS CLINICS L.L.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3220 LANCER ST | ||||||||
| Address2: | |||||||||
| City: | PORTAGE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463684495 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2197648439 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3220 LANCER ST | ||||||||
| Address2: | |||||||||
| City: | PORTAGE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463684495 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2197648439 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2011 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | KIGER | ||||||||
| AuthorizedOfficialFirstName: | DON | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 2194647873 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | IN | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 208D00000X | IN | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice | 2083X0100X | IN | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.