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CLARK MEMORIAL HOSPITAL NPI 1629015953


NPI Information

NPI: 1629015953
Provider Name: CLARK MEMORIAL HOSPITAL

Doing Business As: PRIMARY CARE SERVICES

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 15D2289134

Address:
1806 E 10TH ST
JEFFERSONVILLE, IN
ZIP 47130
Phone: (812) 285-5926
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CLARK MEMORIAL HOSPITAL is a family medicine in Jeffersonville, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CLARK MEMORIAL HOSPITAL NPI is 1629015953. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Primary Care Services.

The provider's business location address is:

1806 E 10TH ST
JEFFERSONVILLE, IN
ZIP 47130
Phone: (812) 285-5926
Fax: (812) 280-5723

The provider's authorized official is Kirk William Strack .
The authorized official title is Vice President Finance Cfo and has the following contact phone number (812) 283-2488.

The CLIA number assigned to this NPI record is 15D2289134 - other - stat lab free standing ed with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 6/2/2006 and was last updated on 7/31/2008.


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
1207R00000XInternal MedicineNo
2208000000XPediatricsNo
3207RC0000XInternal MedicineCardiovascular DiseaseNo
4207X00000XOrthopaedic SurgeryNo
5207Q00000XFamily MedicineYes

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
1CI1990OTHERRAILROAD MEDICARE GROUP
2CD6896OTHERRAILROAD MEDICARE GROUP
3128940MEDICARE PININDIANA
4100074370MEDICAIDINDIANA

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: 5/5/2024

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