Organization
EVANSVILLE OBGYN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HASTETTER (PRACTICE ADMINISTRATOR)
(812) 853-2229
Entity
Organization
Contact information
Practice address
7145 E VIRGINIA ST, EVANSVILLE, IN 47715-9147
(812) 853-2229
Mailing address
7145 E. VIRIGINIA STREET, STE 2000, EVANSVILLE, IN 47715-9147
(812) 962-7894
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01040195A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100180740
—
IN
05
—
200957250A
—
IN
Enumeration date
05/06/2015
Last updated
06/13/2024
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