South Gibson Medical Clinic Inc. | |
7861 S Professional Dr Fort Branch IN 47648-8405 | |
(812) 753-4181 | |
(812) 753-4399 |
Full Name | South Gibson Medical Clinic Inc. |
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Speciality | Family Medicine |
Location | 7861 S Professional Dr, Fort Branch, Indiana |
Authorized Official Name and Position | Quinten B Emerson (PROVIDER/OWNER) |
Authorized Official Contact | 8127534181 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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South Gibson Medical Clinic Inc. Po Box 185 Fort Branch IN 47648-0185 Ph: (812) 753-4181 | South Gibson Medical Clinic Inc. 7861 S Professional Dr Fort Branch IN 47648-8405 Ph: (812) 753-4181 |
NPI Number | 1659538841 |
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Provider Enumeration Date | 05/16/2008 |
Last Update Date | 07/30/2008 |
Medicare PECOS PAC ID | 6002980133 |
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Medicare Enrollment ID | O20080807000141 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659538841 | NPI | - | NPPES |
100122120 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 01027038 (Indiana) | Primary |
Provider Name | Quentin Emerson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427065341 PECOS PAC ID: 3577536911 Enrollment ID: I20080805000506 |
Deaconess Gibson Ft Branch Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7851 S Professional Dr, Fort Branch, IN 47648 Phone: 812-615-5071 Fax: 812-615-5040 | |
Deaconess Clinic I Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 802 E Oak St, Fort Branch, IN 47648 Phone: 812-753-3942 Fax: 812-768-6283 | |
Deaconess Medical Group - Ft Branch Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 802 E Oak St, Fort Branch, IN 47648 Phone: 812-753-3942 Fax: 812-768-6283 | |
Deaconess Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7898 S Professional Dr, Fort Branch, IN 47648 Phone: 812-615-5019 Fax: 812-615-5041 |