Organization
ST. LUKE'S MEDICAL MINISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA GIBSON DNP (PRACTICE MANAGER)
(812) 752-4055
Entity
Organization
Contact information
Practice address
1441 N GARDNER ST, SCOTTSBURG, IN 47170-7751
(812) 752-4055
(812) 752-4188
Mailing address
PO BOX 677, SCOTTSBURG, IN 47170-0677
(812) 752-4055
(812) 752-4188
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200841280A
MEDICAID RHC
IN
05
—
200841280A
—
IN
01
—
CI5526
RAILROAD MEDICARE
IN
Enumeration date
07/13/2006
Last updated
03/05/2026
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