Organization
RISING SUN MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM FULLER (PRESIDENT)
(812) 537-8200
Entity
Organization
Contact information
Practice address
230 6TH ST, RISING SUN, IN 47040-1114
(812) 438-2555
(812) 438-1236
Mailing address
PO BOX 639352, CINCINNATI, OH 45263-9352
(812) 537-8241
(812) 537-1041
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000037297
ANTHEM
IN
01
—
1619948015
INDIVIDUAL NPI
IN
01
—
1841262011
INDIVIDUAL NPI
IN
05
—
200203240A
—
IN
Enumeration date
05/22/2006
Last updated
08/28/2017
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