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Organization

EVANSVILLE MULTI-SPECIALTY CLINIC, PC

Active
Parent organization
EVANSVILLE MULTI-SPECIALTY CLINIC, PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
EVANSVILLE MULTI-SPECIALTY CLINIC, PC
Authorized official
DR. LOTFI HADAD MEDICAL DOCTOR (OWNER)
(812) 475-1948
Entity
Organization

Contact information

Practice address
6140 E COLUMBIA ST, EVANSVILLE, IN 47715-9133
(812) 475-1948
(812) 401-5777
Mailing address
PO BOX 5646, EVANSVILLE, IN 47716-5646
(812) 475-1948
(812) 401-5777

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207RX0202X
Medical Oncology Physician
Primary
363LF0000X
Family Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000391682
BLUE CROSS
IN
05
200806260A
IN
Enumeration date
05/23/2006
Last updated
02/01/2024
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