Organization
PERRY COUNTY MEMORIAL HOSPITAL
Active
Other names
Main Street Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL LEE HINTON (PROVIDER ENROLLMENT)
(812) 772-0589
Entity
Organization
Contact information
Practice address
715 MAIN ST, TELL CITY, IN 47586-1705
(812) 548-4480
(812) 772-0560
Mailing address
715 MAIN ST, TELL CITY, IN 47586-1705
(812) 548-4480
(812) 772-0560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300124476
—
IN
05
—
7101121230
—
KY
Enumeration date
09/16/2025
Last updated
05/05/2026
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