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Organization
CLARK MEMORIAL HOSPITAL
Active
Organization
CLARK MEMORIAL HOSPITAL
Active
Other names
Primary Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIRK WILLIAM STRACK (VICE PRESIDENT FINANCE CFO)
(812) 283-2488
Entity
Organization
Contact information
Practice address
1806 E 10TH ST, JEFFERSONVILLE, IN 47130
(812) 285-5926
(812) 280-5723
Mailing address
1806 E 10TH ST, JEFFERSONVILLE, IN 47130
(812) 285-5926
(812) 280-5723
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100074370
—
IN
01
—
CD6896
RAILROAD MEDICARE GROUP
—
01
—
CI1990
RAILROAD MEDICARE GROUP
—
Enumeration date
06/02/2006
Last updated
07/31/2008
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