Medical school: LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduated: 1974
NPI: 1912988056
Practice Locations (4)
7916 W JEFFERSON BLVD
FORT WAYNE, IN 468044140
1200 W WHITE RIVER BLVD
MUNCIE, IN 473034988
1200 W WHITE RIVER BLVD, RCS PROVIDER ENROLLMENT
MUNCIE, IN 473034988
PO BOX, SUITE 689022
Franklin, TN 370689022
Source: CMS National Downloadable File, September 2026.