Organization
ST. VINCENT CLAY HOSPITAL, INC.
Active
Other names
CLAY CITY MEDICAL CLINIC & ANESTHESIOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
D. BRUCE HAGA (VICE PRESIDENT)
(317) 583-3087
Entity
Organization
Contact information
Practice address
106 W 7TH ST, CLAY CITY, IN 47841-1250
(812) 939-2143
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
09/11/2007
Last updated
09/18/2007
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