Botkin, David John

Botkin, David John is an individual health care provider with primary practice located at 227 N Dixie Way Ste 240 , South Bend IN 46637-3300. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Botkin, David John can be contacted via phone (574) 288-1333.

Contact Information

Primary practice address
227 N Dixie Way Ste 240 South Bend IN 46637-3300
Phone: (574) 288-1333
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20040017 Indiana

Profile Details

NPI number 1487692620
LBN Legal business name Botkin, David John
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Jan 10th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487692620 NPPES
Indiana Other 000000175977 LOCAL BC/BS ID
Indiana MEDICAID 100092140A LOCAL BC/BS ID

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