# PHYSICIANS MEDICAL CENTER LLC

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

## Provider details

- **NPI number:** 1801314455
- **Authorized official:** REBECCA HENRY (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (812) 590-6936

## Contact information

- **Practice address:** 311 E CLIFTY DRIVE, MADISON, IN 47250
- **Practice address phone:** (812) 274-2742
- **Practice address fax:** (812) 274-2899
- **Mailing address:** 4023 REAS LANE ATTN: CREDENTIALING, NEW ALBANY, IN 47150-2228
- **Mailing address phone:** (812) 590-6936
- **Mailing address fax:** (812) 913-4338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 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