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Organization
PHYSICIANS MEDICAL CENTER LLC
Active
Organization
PHYSICIANS MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA HENRY (CREDENTIALING SPECIALIST)
(812) 590-6936
Entity
Organization
Contact information
Practice address
311 E CLIFTY DRIVE, MADISON, IN 47250
(812) 274-2742
(812) 274-2899
Mailing address
4023 REAS LANE ATTN: CREDENTIALING, NEW ALBANY, IN 47150-2228
(812) 590-6936
(812) 913-4338
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
NULL
261QX0100X
Occupational Medicine Clinic/Center
—
NULL
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/05/2017
Last updated
08/01/2018
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