# NORTH CLARK MEDICAL GROUP LLC

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

## Provider details

- **NPI number:** 1376095711
- **Authorized official:** SUHAS GANDHI (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (502) 244-9859

## Contact information

- **Practice address:** 1802 E 10TH ST, JEFFERSONVILLE, IN 47130-6016
- **Practice address phone:** (812) 288-2488
- **Practice address fax:** (812) 288-6603
- **Mailing address:** 2100 MARKET ST STE 101, CHARLESTOWN, IN 47111-9535
- **Mailing address phone:** (812) 503-5100
- **Mailing address fax:** (770) 573-9513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QM2800X | Methadone Clinic | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |
| 324500000X | Substance Abuse Rehabilitation Facility | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 11/02/2016
- **Last updated:** 04/09/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 300010664 | — | IN |
| 05 | — | 7100535740 | — | KY |
| 01 | — | IN3604 | MEDICARE IN | IN |
| 01 | — | K258180 | MEDICARE KY | KY |