Provider Demographics
NPI:1497024426
Name:NORTON-KING'S DAUGHTERS' HEALTH
Entity Type:Organization
Organization Name:NORTON-KING'S DAUGHTERS' HEALTH
Other - Org Name:KINGS DAUGHTERS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-801-0105
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-0159
Mailing Address - Country:US
Mailing Address - Phone:812-801-0715
Mailing Address - Fax:812-265-6603
Practice Address - Street 1:1373 E STATE ROAD 62
Practice Address - Street 2:
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-KING'S DAUGHTERS' HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-20
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN15D0647643291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201224640AMedicaid