Provider Demographics
NPI:1801816673
Name:BROWNSBURG FAMILY MEDICAL CENTER, P.C.
Entity Type:Organization
Organization Name:BROWNSBURG FAMILY MEDICAL CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NETWORK DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GENIEVEE
Authorized Official - Middle Name:S
Authorized Official - Last Name:KLAYER
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN,MBA
Authorized Official - Phone:317-837-5571
Mailing Address - Street 1:1100 SOUTHFIELD DR
Mailing Address - Street 2:SUITE 1370
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4498
Mailing Address - Country:US
Mailing Address - Phone:317-837-5571
Mailing Address - Fax:317-837-5580
Practice Address - Street 1:321 NORTHFIELD DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-2420
Practice Address - Country:US
Practice Address - Phone:317-852-6065
Practice Address - Fax:317-852-2468
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENDRICKS COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-21
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN342100Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER