Organization
SAINT CATHERINE PHYSICIANS SERVICES LLC
Active
Parent organization
SAINT CATHERINE PHYSICIAN SERVICES LLC
Other names
Saint Catherine Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAINT CATHERINE PHYSICIAN SERVICES LLC
Authorized official
KATHRYN F. PRIBBLE (PRACTICE MANAGER)
(812) 256-7579
Entity
Organization
Contact information
Practice address
2100 MARKET ST., CHARLESTOWN, IN 47111
(812) 256-7830
(812) 256-7835
Mailing address
2100 MARKET ST, STE 106, CHARLESTOWN, IN 47111
(812) 256-7830
(812) 256-7835
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01036818A
IN
207R00000X
Internal Medicine Physician
Primary
01044677A
IN
207RP1001X
Pulmonary Disease Physician
10128535A
IN
208600000X
Surgery Physician
01031544A
IN
208600000X
Surgery Physician
01065372A
IN
2086S0129X
Vascular Surgery Physician
01064871A
IN
363L00000X
Nurse Practitioner
71001236A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000549973
ANTHEM BC/BS
IN
05
—
100138490
—
IN
05
—
100204700
—
IN
05
—
200406830
—
IN
05
—
200879370A
—
IN
05
—
20087937A
—
IN
05
—
200893060
—
IN
01
—
71001236A
LISC
IN
01
—
D95574
UPIN
IN
Enumeration date
10/11/2007
Last updated
02/02/2009
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