Organization
MONTICELLO MEDICAL CENTER, LLC
Active
Parent organization
NO
Organization subpart
Yes
Provider details
NPI number
Legal business name
NO
Authorized official
DR. CHARLES R. TRIBBETT M.D. (OWNER)
(574) 583-3333
Entity
Organization
Contact information
Practice address
826 N 6TH ST, MONTICELLO, IN 47960-1752
(574) 583-3333
(574) 583-4785
Mailing address
826 N 6TH ST, MONTICELLO, IN 47960-1752
(574) 583-3333
(574) 583-4785
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
IN
207V00000X
Obstetrics & Gynecology Physician
—
IN
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000099180A
—
IN
05
—
200495560
—
IN
Enumeration date
01/16/2007
Last updated
08/02/2011
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