| Organization Name: | MIDDLEBURY URGENT CARE &OCCMED, P.C. |
| NPI Number: | 1992766059 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEVENS C MARSHALL (PRESIDENT/PHYSICIAN) |
| Mailing Address: | 407 N Main St Middlebury |
| State: | IN US |
| Postal Code: | 465409218 |
| Phone Number: | 5748258184 |
| Fax Number: | 5748256176 |
| NPI Enumeration Date: | 03/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 02001282A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |