Beacon Primary Care LLC
Family Medicine, Addiction Medicine in Fishers, IN. Organization (NPI-2).
NPI number1982155487
StatusActive
Last updated in NPPESJan 7, 2020
Details
- NPI
- 1982155487
- Entity type
- Organization (NPI-2)
- Legal business name
- Beacon Primary Care LLC
- Organization subpart
- No
- Enumeration date
- Oct 19, 2016
- Certification date
- Jan 7, 2020
- Last updated
- Jan 7, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QA0401X | Family Medicine, Addiction Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | – | – |
Practice location
10967 Allisonville Rd Ste 110Fishers, IN 46038-2634
Phone 317-599-5970
Mailing address
10967 Allisonville Rd Ste 110Fishers, IN 46038-2634
Phone 317-559-5970 · Fax 317-559-7971
Authorized official
Peter Donald Farr
Owner
3175597970
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