# ST. VINCENT PHYSICIAN NETWORK, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285731737
- **Authorized official:** KEVIN MCANDREWS (VICE PRESIDENT)
- **Authorized official phone:** (317) 583-3194

## Contact information

- **Practice address:** 105 EAST 2ND STREET, RIDGEVILLE, IN 47380-1325
- **Practice address phone:** (765) 857-2523
- **Mailing address:** 10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/19/2006
- **Last updated:** 08/10/2011