NORTON - KINGS DAUGHTERS HEALTH INC

Provider Demographics

• NPI: 1114955093
• Name: NORTON - KINGS DAUGHTERS HEALTH INC
• Entity Type: Organization
• Organization Name: NORTON - KINGS DAUGHTERS HEALTH INC
• Other - Org Name: THE BETHANY CIRCLE OF KING'S DAUGHTERS' HEALTH OF MADISON INDIANA, INC
• Other - Org Type: Former Legal Business Name
• Authorized Official - Title/Position: CEO
• Authorized Official - First Name: CAROL
• Authorized Official - Middle Name: M
• Authorized Official - Last Name: DOZIER
• Authorized Official - Credentials: CEO
• Authorized Official - Phone: 812-801-0105
• Mailing Address - Street 1: PO BOX 3395
• Mailing Address - City: EVANSVILLE
• Mailing Address - State: IN
• Mailing Address - Zip Code: 47732-3395
• Mailing Address - Country: US
• Mailing Address - Phone: 812-801-0715
• Mailing Address - Fax: 812-265-6603
• Practice Address - Street 1: 1373 E SR 62
• Practice Address - City: MADISON
• Practice Address - State: IN
• Practice Address - Zip Code: 47250-7328
• Practice Address - Country: US
• Practice Address - Phone: 812-801-0715
• Practice Address - Fax: 812-265-6603
• EIN: <UNAVAIL>
• Is Organization Subpart?: Yes
• Parent Organization LBN: NORTON - KINGS DAUGHTERS HEALTH INC
• Parent Organization TIN: <UNAVAIL>
• Enumeration Date: 2006-06-29
• Last Update Date: 2023-01-26

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207Q00000X	Allopathic & Osteopathic Physicians	Family Medicine		Group - Multi-Specialty
No	207L00000X	Allopathic & Osteopathic Physicians	Anesthesiology		Group - Multi-Specialty
No	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine		Group - Multi-Specialty
No	207V00000X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology		Group - Multi-Specialty
No	207X00000X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery		Group - Multi-Specialty
No	207Y00000X	Allopathic & Osteopathic Physicians	Otolaryngology		Group - Multi-Specialty
No	208000000X	Allopathic & Osteopathic Physicians	Pediatrics		Group - Multi-Specialty
No	2085R0001X	Allopathic & Osteopathic Physicians	Radiology	Radiation Oncology	Group - Multi-Specialty
No	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology	Group - Multi-Specialty
No	208600000X	Allopathic & Osteopathic Physicians	Surgery		Group - Multi-Specialty
No	208800000X	Allopathic & Osteopathic Physicians	Urology		Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty
No	363LX0001X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Obstetrics & Gynecology	Group - Multi-Specialty
No	367500000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Anesthetist, Certified Registered		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IN	200140910	Medicaid
KY	65903890	Medicaid
IN	000000056018	Other	ANTHEM BCBS
KY	78901048	Medicaid
IN	100388910	Medicaid
KY	1170897	Other	PASSPORT MEDICAID
IN	100148960	Medicaid
KY	65928533	Medicaid
IN	000000056018	Other	ANTHEM BCBS
KY	1170897	Other	PASSPORT MEDICAID
KY	78901048	Medicaid
IN	701910	Medicare PIN
KY	06005	Medicare PIN
IN	200140910	Medicaid
KY	65928533	Medicaid
IN	412920	Medicare PIN
IN	412850	Medicare PIN