| Southern Indiana Diabetes And Endocrinology Pc | |
|
2019 State St New Albany IN 47150-4921 | |
| (812) 949-5700 | |
| (812) 949-5979 |
| Full Name | Southern Indiana Diabetes And Endocrinology Pc |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 2019 State St, New Albany, Indiana |
| Authorized Official Name and Position | Vasti Broadstone (PHYSICIAN) |
| Authorized Official Contact | 8129495700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Indiana Diabetes And Endocrinology Pc 1008 Fox Hunters Pt New Albany IN 47150-9251 Ph: (812) 949-5700 | Southern Indiana Diabetes And Endocrinology Pc 2019 State St New Albany IN 47150-4921 Ph: (812) 949-5700 |
| NPI Number | 1790843829 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 03/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790843829 | NPI | - | NPPES |
| 200332950A | Medicaid | IN | |
| 65935603 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
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