Organization
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC.
Active
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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