Organization
ST CLARE HEALTH NETWORK
Active
Parent organization
ST. CLARE MEDICAL CENTER
Other names
Crawfordsville Obstetrics and Gynecology
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. CLARE MEDICAL CENTER
Authorized official
JIM SIEMERS (EXECUTIVE DIRECTOR)
(765) 362-3100
Entity
Organization
Contact information
Practice address
1630 LAFAYETTE RD, SUITE 200, CRAWFORDSVILLE, IN 47933-1090
(765) 364-9720
(765) 364-9740
Mailing address
1710 LAFAYETTE RD, CRAWFORDSVILLE, IN 47933-1033
(765) 364-9720
(765) 364-9740
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000386762
ANTHEM PIN
IN
05
—
200214400B
—
IN
Enumeration date
11/13/2006
Last updated
07/24/2008
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