Organization
ST CATHERINE PHYSICIAN SERVICES OF INDIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LANE (CEO)
(812) 256-3301
Entity
Organization
Contact information
Practice address
417 WEST COLONEL WAY, HENRYVILLE, IN 47126
(812) 294-1470
Mailing address
417 WEST COLONEL WAY, HENRYVILLE, IN 47126
(812) 294-1470
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01052944A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000550438
ANTHEM BC/BS
IN
01
—
H30374
UPIN
IN
Enumeration date
12/27/2007
Last updated
03/26/2008
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