| Petersburg Family Medicine | |
|
1003 E Illinois St Petersburg IN 47567 | |
| (812) 354-3458 | |
| (812) 354-3459 |
| Full Name | Petersburg Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1003 E Illinois St, Petersburg, Indiana |
| Authorized Official Name and Position | Edward Kyle Bennett (PRESIDENT AND CEO) |
| Authorized Official Contact | 8129960507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Petersburg Family Medicine Po Box 1028 Jasper IN 47547-1028 Ph: (812) 996-8478 | Petersburg Family Medicine 1003 E Illinois St Petersburg IN 47567 Ph: (812) 354-3458 |
| NPI Number | 1689770083 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 07/17/2018 |
| Medicare PECOS PAC ID | 4587578042 |
|---|---|
| Medicare Enrollment ID | O20130625000681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689770083 | NPI | - | NPPES |
| 200048850K | Medicaid | IN | |
| CB3118 | Other | IN | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
Petersburg Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 E Main St, Petersburg, IN 47567 Phone: 812-354-8426 Fax: 812-354-9134 | |
Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1814 E State Road 56 Fl 1, Petersburg, IN 47567 Phone: 812-494-9514 Fax: 812-494-9515 | |
Good Samaritan Hospital Physician Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 E Main St, Suite 110, Petersburg, IN 47567 Phone: 812-354-8426 Fax: 812-354-9134 | |
Deaconess Medical Group - Petersburg Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 W Pike Ave, Petersburg, IN 47567 Phone: 812-354-1052 Fax: 812-354-8280 | |
Good Samaritan Family Health Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1810 E State Road 56, Petersburg, IN 47567 Phone: 810-494-9515 Fax: 812-494-9514 | |
Good Samaritan Family Health Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 E Main St Ste 110, Petersburg, IN 47567 Phone: 812-354-8785 Fax: 812-354-8786 |