# PERRY COUNTY OB/GYN

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PERRY COUNTY MEMORIAL HOSPITAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033100367
- **Legal business name:** PERRY COUNTY MEMORIAL HOSPITAL
- **Authorized official:** JOSEPH A. STUBER (CEO)
- **Authorized official phone:** (812) 547-7011

## Contact information

- **Practice address:** 109 US HIGHWAY 66 E, TELL CITY, IN 47586-2755
- **Practice address phone:** (812) 547-3447
- **Practice address fax:** (812) 547-9543
- **Mailing address:** 109 US HIGHWAY 66 E, TELL CITY, IN 47586-2755
- **Mailing address phone:** (812) 547-9549
- **Mailing address fax:** (812) 547-9543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/04/2005
- **Last updated:** 03/23/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000513877 | ANTHEM | IN |
| 05 | — | 100270000B | — | IN |
| 05 | — | 100270000D | — | IN |
| 01 | — | 15D1003624 | CLIA | IN |
| 05 | — | 7100026900 | — | KY |
| 01 | — | DF7541 | RAILROAD MEDICARE | IN |