Organization
ST MARY'S BREAST CENTER, LLC
Active
Parent organization
SETON HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
SETON HEALTH
Authorized official
KATHY J HALL (MANAGER)
(812) 471-1591
Entity
Organization
Contact information
Practice address
100 ST MARYS EPWORTH XING, STE. A500, NEWBURGH, IN 47630-9698
(812) 485-4437
(812) 485-6890
Mailing address
PO BOX 138, EVANSVILLE, IN 47701-0138
(812) 471-1591
(812) 471-6650
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100468730
—
IN
05
—
7100138240
—
KY
Enumeration date
10/20/2005
Last updated
03/26/2014
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