Organization
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC.
Active
Other names
Fayette Salaried Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL WHITE (CEO)
(765) 825-5131
Entity
Organization
Contact information
Practice address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331-2833
(765) 827-8933
(765) 827-7863
Mailing address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331-2833
(765) 825-5131
(765) 827-7863
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100268220
—
IN
Enumeration date
03/27/2006
Last updated
04/08/2016
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