KOSCIUSKO MEDICAL GROUP LLC NPI 1932349594

NPI Information

NPI: 1932349594
Provider Name: KOSCIUSKO MEDICAL GROUP LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
2235 DUBOIS DR
WARSAW, IN
ZIP 46580
Phone: (574) 267-8189
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KOSCIUSKO MEDICAL GROUP LLC is a family medicine in Warsaw, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. KOSCIUSKO MEDICAL GROUP LLC NPI is 1932349594. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2235 DUBOIS DR
WARSAW, IN
ZIP 46580-212
Phone: (574) 267-8189

The provider's authorized official is Jennifer L Jackson .
The authorized official title is Sr Director Provider Enrollment and has the following contact phone number (615) 465-3334.

The enumeration date for this NPI number is 2/23/2009 and was last updated on 11/12/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	174400000X	Specialist		No
2	207R00000X	Internal Medicine		No
3	207RH0003X	Internal Medicine	Hematology & Oncology	No
4	207X00000X	Orthopaedic Surgery		No
5	208000000X	Pediatrics		No
6	208600000X	Surgery		No
7	363A00000X	Physician Assistant		No
8	363LF0000X	Nurse Practitioner	Family	No
9	207Q00000X	Family Medicine		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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