| University Of Evansville | |
|
1931 Lincoln Ave Suite A Evansville IN 47722-1000 | |
| (812) 488-3350 | |
| Not Available |
| Full Name | University Of Evansville |
|---|---|
| Speciality | Clinic/Center |
| Location | 1931 Lincoln Ave Suite A, Evansville, Indiana |
| Authorized Official Name and Position | Donna Teague (EXEC VP OF FISCAL AFFAIRS) |
| Authorized Official Contact | 8124882212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| University Of Evansville 1800 Lincoln Ave Evansville IN 47722-1000 Ph: () - | University Of Evansville 1931 Lincoln Ave Suite A Evansville IN 47722-1000 Ph: (812) 488-3350 |
| NPI Number | 1265211288 |
|---|---|
| Provider Enumeration Date | 09/28/2023 |
| Last Update Date | 01/18/2024 |
| Certification Date | 01/18/2024 |
| Medicare PECOS PAC ID | 8426496001 |
|---|---|
| Medicare Enrollment ID | O20240402000569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265211288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kevin D Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952600413 PECOS PAC ID: 5890097091 Enrollment ID: I20160105001949 |
| Provider Name | William G Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356012009 PECOS PAC ID: 8123426277 Enrollment ID: I20211005000469 |
| Provider Name | Matthew Powless |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811653256 PECOS PAC ID: 5799172953 Enrollment ID: I20220419000792 |
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