Medical school: OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1974
NPI: 1225163611
Practice Locations (3)
P O BOX, SUITE 6459
Kokomo, IN 469046459
702 W ALTO RD
KOKOMO, IN 469024907
3562 E US HWY 30
WARSAW, IN 465806720
Source: CMS National Downloadable File, September 2026.