ST MARY'S BREAST CENTER LLC NPI 1073502290

NPI Information

  • NPI: 1073502290
  • Provider Name: ST MARY'S BREAST CENTER, LLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Address: 100 ST MARYS EPWORTH XING
    STE. A500
    NEWBURGH, IN
    ZIP 47630
  • Phone: (812) 485-4437

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NPI Details

ST MARY'S BREAST CENTER, LLC is a diagnostic radiology radiology in Newburgh, IN. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. ST MARY'S BREAST CENTER, LLC NPI is 1073502290. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 ST MARYS EPWORTH XING
STE. A500
NEWBURGH, IN
ZIP 47630-698
Phone: (812) 485-4437
Fax: (812) 485-6890

The provider's authorized official is Kathy J Hall .
The authorized official title is Manager and has the following contact phone number (812) 471-1591.

The enumeration date for this NPI number is 10/20/2005 and was last updated on 3/26/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208100000XPhysical Medicine & RehabilitationNo
22085R0202XRadiologyDiagnostic RadiologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17100138240MEDICAIDKENTUCKY
2100468730MEDICAIDINDIANA
3636080MEDICARE ID-TYPE UNSPECIFIEDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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