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Contact Information

J S MIDMORE MD PC
3156 WILLOWCREEK RD
PORTAGE, IN46368-4424
 Phone: 219-547-5999
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for J S MIDMORE MD PC

NPI # 1093927063
LBN Legal business name J S MIDMORE MD PC
Authorized official JOHN MIDMORE - (PHYSICIAN OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/04/2007
Last updated 10/10/2014 - About 12 years ago
Identifiers
IN License # 0104887A
IN Medicaid 100340370B
IN Other DU8259 RR MCR
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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