Organization
OBASEKI INDIANA FAMILY HEALTH CLINIC, PROF. CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ART O OBASEKI NP (PRESIDENT)
(812) 491-8765
Entity
Organization
Contact information
Practice address
645 CANAL ST, EVANSVILLE, IN 47713-2441
(812) 491-8765
(812) 491-8766
Mailing address
645 CANAL ST, EVANSVILLE, IN 47713-2441
(812) 491-8765
(812) 491-8766
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
01039780A
IN
364SF0001X
Family Health Clinical Nurse Specialist
Primary
71000903A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000354966
ANTHEM
—
05
—
200512070
—
IN
Enumeration date
01/29/2013
Last updated
01/29/2013
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