Provider Demographics
NPI:1518916048
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, IN
Other - Org Type:Former Legal Business Name
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 3285
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47732-3285
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 - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-7328
Practice Address - Country:US
Practice Address - Phone:812-801-0117
Practice Address - Fax:812-265-6603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1064346OtherPASSPORT HEALTH MEDICAID
IN100269210AMedicaid
KY2434429000OtherPASSPORT ADVANTAGE
IN000000054324OtherANTHEM BLUE CROSS
KY01340025Medicaid
IN41UB01POtherSIHO
OH4710754Medicaid
KY2434429000OtherPASSPORT ADVANTAGE