Basic Information
| Provider Information | |||||||||
| NPI: | 1801816673 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BROWNSBURG FAMILY MEDICAL CENTER, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 SOUTHFIELD DR | ||||||||
| Address2: | SUITE 1370 | ||||||||
| City: | PLAINFIELD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461684498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178375571 | ||||||||
| FaxNumber: | 3178375580 | ||||||||
| Practice Location | |||||||||
| Address1: | 321 NORTHFIELD DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BROWNSBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461122420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178526065 | ||||||||
| FaxNumber: | 3178522468 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 12/06/2013 | ||||||||
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| AuthorizedOfficialLastName: | KLAYER | ||||||||
| AuthorizedOfficialFirstName: | GENIEVEE | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | NETWORK DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3178375571 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HENDRICKS COUNTY HOSPITAL | ||||||||
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| AuthorizedOfficialCredential: | RN,BSN,MBA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.