Organization
TELL CITY PEDIATRICS
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) 547-3447
(812) 547-9543
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000359519
ANTHEM
IN
01
—
15D1038972
CLIA
IN
05
—
200398420A
—
IN
05
—
65943706
—
KY
Enumeration date
11/04/2005
Last updated
03/11/2010
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