| Deaconess Medical Group - Ft Branch | |
|
802 E Oak St Fort Branch IN 47648-1666 | |
| (812) 753-3942 | |
| (812) 768-6283 |
| Full Name | Deaconess Medical Group - Ft Branch |
|---|---|
| Speciality | Family Medicine |
| Location | 802 E Oak St, Fort Branch, Indiana |
| Authorized Official Name and Position | Richard M Stivers (SR VICE PRESIDENT, CFO) |
| Authorized Official Contact | 8124503296 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deaconess Medical Group - Ft Branch Po Box 3407 Evansville IN 47733-3407 Ph: (812) 450-6815 | Deaconess Medical Group - Ft Branch 802 E Oak St Fort Branch IN 47648-1666 Ph: (812) 753-3942 |
| NPI Number | 1306957097 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 10/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306957097 | NPI | - | NPPES |
| CG1119 | Other | IN | RR MCARE GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Deaconess Gibson Ft Branch Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7851 S Professional Dr, Fort Branch, IN 47648 Phone: 812-615-5071 Fax: 812-615-5040 | |
Deaconess Clinic I Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 802 E Oak St, Fort Branch, IN 47648 Phone: 812-753-3942 Fax: 812-768-6283 | |
Deaconess Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7898 S Professional Dr, Fort Branch, IN 47648 Phone: 812-615-5019 Fax: 812-615-5041 | |
South Gibson Medical Clinic Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7861 S Professional Dr, Fort Branch, IN 47648 Phone: 812-753-4181 Fax: 812-753-4399 |