| Evansville Obgyn | |
|
7145 E Virginia St Evansville IN 47715 | |
| (812) 477-7111 | |
| (812) 477-7117 |
| Full Name | Evansville Obgyn |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 7145 E Virginia St, Evansville, Indiana |
| Authorized Official Name and Position | Lisa K Hastetter (ADMINISTRATOR) |
| Authorized Official Contact | 8124766161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evansville Obgyn 7145 E Virginia St Suite 2000 Evansville IN 47715-9144 Ph: (812) 962-7890 | Evansville Obgyn 7145 E Virginia St Evansville IN 47715 Ph: (812) 477-7111 |
| NPI Number | 1114059839 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 04/29/2021 |
| Certification Date | 04/29/2021 |
| Medicare PECOS PAC ID | 7416054069 |
|---|---|
| Medicare Enrollment ID | O20070516000474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114059839 | NPI | - | NPPES |
| 1001807A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207V00000X | Obstetrics & Gynecology | () | Primary |
| Provider Name | Thomas S Hastetter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992770127 PECOS PAC ID: 7517064157 Enrollment ID: I20070516000463 |
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