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Contact Information

ST. MARY'S PHYSICIAN NETWORK LLC.
3700 WASHINGTON AVENUE
EVANSVILLE, IN47750-0001
 Phone: 812-485-1220
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Acute Care

363LA2100X 50 Nurse Practitioner
 

Endocrinology, Diabetes & Metabolism

207RE0101X 11 Physician/Internal Medicine
 

Family

363LF0000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Nephrology

207RN0300X 11 Physician/Internal Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Pediatrics

363LP0200X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Sleep Medicine

2080S0012X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for ST. MARY'S PHYSICIAN NETWORK LLC.

NPI # 1639114143
LBN Legal business name ST. MARY'S PHYSICIAN NETWORK LLC.
Authorized official KIMBERLY HODGKINSON - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 06/18/2006
Last updated 08/17/2018 - About 8 years ago
Identifiers
IN Medicaid 200829650
KY Medicaid 65945420
IN Other DF3251 RR MEDICARE GRP#
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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