| South Gibson Medical Clinic Inc. | |
|
7861 S Professional Dr Fort Branch IN 47648-8405 | |
| (812) 753-4181 | |
| (812) 753-4399 |
| Full Name | South Gibson Medical Clinic Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 7861 S Professional Dr, Fort Branch, Indiana |
| Authorized Official Name and Position | Quinten B Emerson (PROVIDER/OWNER) |
| Authorized Official Contact | 8127534181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Gibson Medical Clinic Inc. Po Box 185 Fort Branch IN 47648-0185 Ph: (812) 753-4181 | South Gibson Medical Clinic Inc. 7861 S Professional Dr Fort Branch IN 47648-8405 Ph: (812) 753-4181 |
| NPI Number | 1659538841 |
|---|---|
| Provider Enumeration Date | 05/16/2008 |
| Last Update Date | 07/30/2008 |
| Medicare PECOS PAC ID | 6002980133 |
|---|---|
| Medicare Enrollment ID | O20080807000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659538841 | NPI | - | NPPES |
| 100122120 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01027038 (Indiana) | Primary |
| Provider Name | Quentin Emerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427065341 PECOS PAC ID: 3577536911 Enrollment ID: I20080805000506 |
Deaconess Clinic, Inc 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 Hospital, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare 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 |