Organization
PERRY COUNTY OB/GYN
Active
Parent organization
PERRY COUNTY MEMORIAL HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
PERRY COUNTY MEMORIAL HOSPITAL
Authorized official
JOSEPH A. STUBER (CEO)
(812) 547-7011
Entity
Organization
Contact information
Practice address
109 US HIGHWAY 66 E, TELL CITY, IN 47586-2755
(812) 547-3447
(812) 547-9543
Mailing address
109 US HIGHWAY 66 E, TELL CITY, IN 47586-2755
(812) 547-9549
(812) 547-9543
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000513877
ANTHEM
IN
05
—
100270000B
—
IN
05
—
100270000D
—
IN
01
—
15D1003624
CLIA
IN
05
—
7100026900
—
KY
01
—
DF7541
RAILROAD MEDICARE
IN
Enumeration date
11/04/2005
Last updated
03/23/2010
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