| Patrick W Stack, MD | |
|
1373 E Sr 62, Madison, IN 47250 | |
| (812) 801-0300 | |
| (812) 801-0585 |
| Full Name | Patrick W Stack |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 1373 E Sr 62, Madison, Indiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710918891 | NPI | - | NPPES |
| 412626P | Other | IN | SIHO |
| 4370916 | Other | AETNA | |
| 000000042211 | Other | IN | ANTHEM BCBS |
| 1082594 | Other | KY | PASSPORT KY MEDICAID |
| 100148850A | Medicaid | IN | |
| 64759798 | Medicaid | KY | |
| 2435578000 | Other | KY | PASSPORT ADVANTAGE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 01033161 (Indiana) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Patrick W Stack, MD Po Box 3395, Evansville, IN 47732-3395 Ph: () - | Patrick W Stack, MD 1373 E Sr 62, Madison, IN 47250 Ph: (812) 801-0300 |
Dr. Jennifer A Stone, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1373 E State Road 62, Madison, IN 47250 Phone: 812-801-0300 | |
Dr. Jenna Aleea Ali, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 1373 E Sr 62, Madison, IN 47250 Phone: 812-801-0300 | |
Stephanie Nicole Morgan, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2420 Wilson Ave, Madison, IN 47250 Phone: 812-292-4464 | |
Susan M Stack, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1373 E Sr 62, Madison, IN 47250 Phone: 812-801-0300 Fax: 812-801-0585 | |
Dr. Sarah R. Marshall, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 630 Broadway St, Madison, IN 47250 Phone: 812-273-5437 Fax: 812-801-8005 | |
Diamond N Harris, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1373 E State Road 62 # Level2, Madison, IN 47250 Phone: 812-801-0300 Fax: 812-801-0585 |