Provider Demographics
NPI:1902975881
Name:FAMILY PRACTICE ASSOCIATES
Entity Type:Organization
Organization Name:FAMILY PRACTICE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-925-0403
Mailing Address - Street 1:1314 E 7TH ST
Mailing Address - Street 2:#101
Mailing Address - City:AUBURN
Mailing Address - State:IN
Mailing Address - Zip Code:46706-2535
Mailing Address - Country:US
Mailing Address - Phone:260-925-0403
Mailing Address - Fax:260-925-9545
Practice Address - Street 1:1314 E 7TH ST
Practice Address - Street 2:#101
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-2535
Practice Address - Country:US
Practice Address - Phone:260-925-0403
Practice Address - Fax:260-925-9545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01034432207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty