Provider Demographics
NPI:1376751891
Name:DIGESTIVE CARE OF EVANSVILLE PC
Entity Type:Organization
Organization Name:DIGESTIVE CARE OF EVANSVILLE PC
Other - Org Name:GASTROENTEROLOGY ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:W
Authorized Official - Last Name:MOORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-477-6103
Mailing Address - Street 1:3800 VENETIAN WAY
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8257
Mailing Address - Country:US
Mailing Address - Phone:812-477-6103
Mailing Address - Fax:812-477-4897
Practice Address - Street 1:3800 VENETIAN WAY
Practice Address - Street 2:STE 200
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8257
Practice Address - Country:US
Practice Address - Phone:812-477-6103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207RG0100X, 363LA2100X
363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty