Provider Demographics
NPI:1093768913
Name:SWEETS, DONNA C (DO)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:C
Last Name:SWEETS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 359
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47703-0359
Mailing Address - Country:US
Mailing Address - Phone:812-485-1220
Mailing Address - Fax:812-485-8544
Practice Address - Street 1:801 SAINT MARYS DR
Practice Address - Street 2:SUITE 309E
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0511
Practice Address - Country:US
Practice Address - Phone:812-485-1850
Practice Address - Fax:812-485-1855
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002168207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000485714OtherANTHEM PIN
IN237890OtherMEDICARE GRP #
KY65945420OtherMEDICAID GROUP
INDF3251OtherRAILROAD GROUP
IN205023387OtherTAX ID
IN200264690Medicaid
IN200829650AOtherMEDICAID GRP #
KY64095243Medicaid
INP00362823OtherRAILROAD INDIVIDUAL
IN200264690Medicaid
IN237890NMedicare PIN