| Medical Of Dubois A Professional Corporation | |
|
695 3rd Ave Jasper IN 47546-3602 | |
| (812) 634-6824 | |
| (812) 848-2277 |
| Full Name | Medical Of Dubois A Professional Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 695 3rd Ave, Jasper, Indiana |
| Authorized Official Name and Position | Thomas E Field (PRESIDENT) |
| Authorized Official Contact | 8126346824 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Of Dubois A Professional Corporation 695 3rd Ave Jasper IN 47546-3602 Ph: (812) 634-6824 | Medical Of Dubois A Professional Corporation 695 3rd Ave Jasper IN 47546-3602 Ph: (812) 634-6824 |
| NPI Number | 1184719155 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 05/26/2016 |
| Medicare PECOS PAC ID | 0749457315 |
|---|---|
| Medicare Enrollment ID | O20120123000331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184719155 | NPI | - | NPPES |
| DF6038 | Other | IN | MEDICARE RAILROAD |
| 000000310221 | Other | IN | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 01025667 (Indiana) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | 01025667 (Indiana) | Primary |
| Provider Name | Janet Lyn Baugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275629511 PECOS PAC ID: 0143280388 Enrollment ID: I20041013000160 |
| Provider Name | Karen Beckman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356764476 PECOS PAC ID: 4880825868 Enrollment ID: I20140317001282 |
| Provider Name | Elizabeth A Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053861195 PECOS PAC ID: 5597047209 Enrollment ID: I20170112001938 |
| Provider Name | Michael Snell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588226856 PECOS PAC ID: 8527365857 Enrollment ID: I20190730000049 |
| Provider Name | Annette R Klem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659922789 PECOS PAC ID: 0648501809 Enrollment ID: I20191019000115 |
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