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Contact Information

SALLY J SIDMAN, MD
1206 E. NATIONAL AVENUE
BRAZIL, IN47834
 Phone: 812-442-2700
 Fax: 812-442-2710
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for SALLY J SIDMAN · (Female)

NPI # 1215952601
Status Active
Credentials MD
Entity Individual
Enumeration date 07/13/2006
Last updated 03/27/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • CA License # G74927
  • IL License # 036-098644
  • IN License # 01042578A
  • IL Medicaid 036098644
  • IN Medicaid 100381480
  • IL Other 036098644 BLUE SHIELD
  • IN Other 000000602172 BLUE SHIELD
Hospital affiliation(s)
  • ST VINCENT CLAY HOSPITAL INC - (Critical Access)
    1206 E NATIONAL AVE
    BRAZIL, IN 47834
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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