National Provider Identifier Database

SUSAN M STACK, MD – NPI #1588696314
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.


Contact Information

SUSAN M STACK, MD
1373 E SR 62
MADISON, IN47250
Phone: 812-801-0300
Fax: 812-801-0585
Website:
Specialty Taxonomy Code
* Pediatrics 208000000X

* Indicates primary specialty

NPI Profile & details for SUSAN M STACK

NPI Number 1588696314
Credentials MD
Entity Individual
Enumeration date 07/06/2006
Last updated 02/20/2019 - About 7 years ago
Sole proprietor1 No
Identifiers
  • IN License #: 01033162
  • IN Medicaid: 100148860A
  • KY Medicaid: 64759780
  • Other: 4370872 AETNA
  • IN Other: 000000042214 ANTHEM BCBS
  • IN Other: 410015P SIHO
  • KY Other: 1082593 PASSPORT KY MEDICAID
Hospital affiliation n/a

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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