Provider Demographics
NPI:1376054460
Name:R2 MEDICAL CENTERS, LLC
Entity Type:Organization
Organization Name:R2 MEDICAL CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:H
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:219-696-8916
Mailing Address - Street 1:2072B E COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:IN
Mailing Address - Zip Code:46356-2116
Mailing Address - Country:US
Mailing Address - Phone:801-494-9769
Mailing Address - Fax:219-696-6880
Practice Address - Street 1:2072B E COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:IN
Practice Address - Zip Code:46356-2116
Practice Address - Country:US
Practice Address - Phone:801-494-9769
Practice Address - Fax:219-696-6880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty